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Higher levels of disease-related knowledge reduce medical acceleration in patients with inflammatory bowel disease.

ABSTRACT: BACKGROUND AND AIMS:The disease-related knowledge levels in patients with inflammatory bowel disease (IBD) are important because it could affect the self-management ability and adaptive coping strategies. We set out to determine whether higher levels of disease-related knowledge reduce medical acceleration. METHODS:We evaluated the levels of disease-related knowledge in all patients at the time of enrollment for SNUBH IBD cohort using the validated IBD-KNOW questionnaire. Clinical data were prospectively collected and the factors related to step-up therapy were analyzed. Step-up therapy was defined as the new use of corticosteroids, immunomodulators, or biologics after the enrollment. RESULTS:Between April 2017 and January 2019, 298 patients were enrolled (mean age, 39.8 years; males, 69.5%); 193 patients (64.8%) had ulcerative colitis and 105 (35.2%) had Crohn's disease. The mean disease duration was 35.8 months. During the mean follow-up of 14.7 months, 90 patients (30.2%) underwent step-up therapy and 208 (69.8%) underwent continuous therapy. The prevalence of continuous therapy increased with increasing IBD-KNOW scores (p for trend = 0.019). Cox proportional hazards analysis revealed that high IBD-KNOW scores (? 16) (hazards ratio [HR]: 0.498, 95% confidence interval [CI]: 0.276-0.897, p = 0.020) was negatively associated with the step-up therapy. CONCLUSIONS:Higher disease-related knowledge could reduce the requirement of step-up therapy in IBD. The IBD-KNOW score was independently predictive of step-up therapy.

SUBMITTER: Park J

PROVIDER: S-EPMC7274391 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Higher levels of disease-related knowledge reduce medical acceleration in patients with inflammatory bowel disease.

Park Jihye J Yoon Hyuk H Shin Cheol Min CM Park Young Soo YS Kim Nayoung N Lee Dong Ho DH

PloS one 20200605 6

<h4>Background and aims</h4>The disease-related knowledge levels in patients with inflammatory bowel disease (IBD) are important because it could affect the self-management ability and adaptive coping strategies. We set out to determine whether higher levels of disease-related knowledge reduce medical acceleration.<h4>Methods</h4>We evaluated the levels of disease-related knowledge in all patients at the time of enrollment for SNUBH IBD cohort using the validated IBD-KNOW questionnaire. Clinical ...[more]

PMID: 32502199

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Project description:Background:Inflammatory bowel disease (IBD), is a debilitating group of chronic diseases including Crohn's Disease (CD) and ulcerative colitis (UC), which causes inflammation of the gut and affects millions of people worldwide. At different taxonomic levels, the structure of the gut microbiota is significantly altered in IBD patients compared to that of healthy individuals. However, it is unclear how these IBD-affected bacterial groups are related to other common bacteria in the gut, and how they are connected across different disease conditions at the global scale. Results:In this study, using faecal samples from patients with IBD, we show through diversity analysis of the microbial community structure based on the 16S rRNA gene that the gut microbiome of IBD patients is less diverse compared to healthy individuals. Furthermore, we have identified which bacterial groups change in abundance in both CD and UC compared to healthy controls. A substantial imbalance was observed across four major bacterial phyla including Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria, which together constitute?>?98% of the gut microbiota. Next, we reconstructed a bacterial family co-abundance network based on the correlation of abundance profiles obtained from the public gut microbiome data of?>?22,000 samples of faecal and gut biopsies taken from both diseased and healthy individuals. The data was compiled using the EBI metagenomics database (Mitchell et al. in Nucleic Acids Res 46:D726-D735, 2018). By mapping IBD-altered bacterial families to the network, we show that the bacterial families which exhibit an increased abundance in IBD conditions are not well connected to other groups, implying that these families generally do not coexist together with common gut organisms. Whereas, the bacterial families whose abundance is reduced or did not change in IBD conditions compared to healthy conditions are very well connected to other bacterial groups, suggesting they are highly important groups of bacteria in the gut that can coexist with other bacteria across a range of conditions. Conclusions:IBD patients exhibited a less diverse gut microbiome compared to healthy individuals. Bacterial groups which changed in IBD patients were found to be groups which do not co-exist well with common commensal gut bacteria, whereas bacterial groups which did not change in patients with IBD were found to commonly co-exist with commensal gut microbiota. This gives a potential insight into the dynamics of the gut microbiota in patients with IBD.

Project description:IntroductionThere is a high degree of perceived stigma among adults with inflammatory bowel disease (IBD), with up to 84% considering a social stereotype against them due to their condition. This may negatively impact their treatment adherence and quality of life, as well as practical issues such as gaining urgent access to public bathroom facilities. It has been demonstrated that higher public knowledge levels can reduce public stigma, yet little is known about the general level of understanding of IBD in the community. A study was performed to ascertain the public knowledge levels of IBD in Christchurch, New Zealand, using a validated assessment tool.ObjectivesThe aims of this study were to implement a validated knowledge survey (IBD-KID2) among members of the general public in Christchurch, New Zealand, and to assess the level of understanding about IBD.MethodsRecruitment took place at a Health Research and Education showcase event at the University of Otago (Christchurch), which is a free event open to members of the public. All people over the age of 8 years were invited to participate. Demographic information was collected and the disease-specific knowledge assessment survey IBD-KID2 completed by all participants consenting to the research.ResultsOne hundred people consented to the study, and the mean age 39.9 was years (SD 20, range 12-82 years). Of these 100 participants, 71 were female and 71 had a post-secondary education. Twelve participants had a family history of IBD. The mean IBD-KID2 score was 8.7 (SD 2.9), equal to a percentage total score of 58%. No independent variable was found to be significantly associated with IBD-KID2 scores. The frequency of correct answers showed knowledge deficiencies in the areas of nutrition, treatment, growth, and the cause of IBD.ConclusionsThis study highlighted knowledge deficiencies among members of the general public in Christchurch, New Zealand. These topics may be addressed with awareness campaigns in order to maximise community support for adults and children with IBD.

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Higher levels of disease-related knowledge reduce medical acceleration in patients with inflammatory bowel disease.

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Higher levels of disease-related knowledge reduce medical acceleration in patients with inflammatory bowel disease.

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