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Hilley P, Wong D, De Cruz P. How Does an Integrated Pharmacist Add Value in the Management of Inflammatory Bowel Disease in the Era of Values-Based Healthcare? Inflamm Bowel Dis 2024:izae196. [PMID: 39207321 DOI: 10.1093/ibd/izae196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Indexed: 09/04/2024]
Abstract
The World Health Organization has recommended that the management of chronic diseases such as inflammatory bowel disease (IBD) should be undertaken using an integrated approach delivered by a multidisciplinary team. Although the composition of an IBD multidisciplinary team has been well described, the inclusion of an IBD pharmacist as a core member has been more recent, with variable uptake within IBD services internationally. While pharmacists continue to play the traditional role of safe prescribing and monitoring of immunosuppressive therapies, their role within the IBD team is rapidly expanding; however, the value, in terms of both clinical outcomes as well as financial savings (where available), which they add to IBD services has been less well described. In this narrative review, we perform a comprehensive evaluation of the literature detailing the expanding roles that IBD pharmacists play and describe opportunities that exist for integrated pharmacists to add value to IBD service delivery. Medication and adherence counseling, immunosuppressive monitoring, uptake of biosimilars, therapeutic drug monitoring, health promotion and prevention appear to be key areas where integrated pharmacists can add the most value to IBD patients and services. In particular, integrated IBD pharmacists can improve patient outcomes via rigorous monitoring pre and post initiation of drug therapies; focused medication counseling; advice on improving adherence; implementation of novel approaches to medication usage, and; strategies to help sustain IBD service delivery. These data can be used to further build a case for those seeking to add pharmacists to their team/services. Future studies should focus on evaluating the impact of an integrated IBD pharmacist on quality-of-care delivery together with the clinical and financial value added to IBD services compared to services that lack an integrated IBD pharmacist role.
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Affiliation(s)
- Patrick Hilley
- Department of Gastroenterology, The Austin Hospital, Melbourne, Australia
- Department of Medicine, Austin Academic Centre, University of Melbourne, Melbourne, Australia
- Department of Pharmacy, The Austin Hospital, Melbourne, Australia
| | - Darren Wong
- Department of Gastroenterology, The Austin Hospital, Melbourne, Australia
- Department of Medicine, Austin Academic Centre, University of Melbourne, Melbourne, Australia
| | - Peter De Cruz
- Department of Gastroenterology, The Austin Hospital, Melbourne, Australia
- Department of Medicine, Austin Academic Centre, University of Melbourne, Melbourne, Australia
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Ley D, Lazarus S, Forati AM, Farraye FA, Smith R, Hayney MS, Caldera F. High Rates of Seroprotection to Hepatitis B After a Hepatitis B Challenge Dose in Previously Vaccinated Patients with Inflammatory Bowel Disease on Immunosuppressive Therapy. Dig Dis Sci 2024; 69:3051-3060. [PMID: 38907090 DOI: 10.1007/s10620-024-08527-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Healthy populations have high rates of sustained vaccine-induced seroprotection to hepatitis B virus, but previous studies in immunosuppressed patients with inflammatory bowel disease (IBD) have shown suboptimal seroprotection rates. A challenge dose of hepatitis B vaccine (HepB) is recommended in previously vaccinated individuals who are seronegative to elicit an anamnestic response and determine if they are seroprotected. The aim of our study was to determine sustained seroprotection rates to hepatitis B vaccine (HepB) in patients with IBD. METHODS This was a single-center prospective study of patients with IBD previously vaccinated with a three dose HepB series. Patients had a hepatitis B surface antibody (anti-HBs) drawn; if it was below 10 mIU/mL, they received a challenge dose of the HepB vaccine to assess for anamnestic response and sustained seroprotection. The primary outcome was to determine the rate of sustained seroprotection (anti-HBs ≥ 10). RESULTS A total of 168 patients met inclusion criteria, mean age 35.7 years ± 13.6 standard deviation (SD). Initially 120 (71.4%) had anti-HBs ≥ 10 mIU/mL, with median anti-HBs of 37 mIU/mL (interquartile range 0-234); 48 (28.6%) needed a challenge dose, of which 34 responded with anti-HBs ≥ 10 mIU/mL. In total, 154 (91.7%) demonstrated sustained seroprotection to HepB. Those not seroprotected were more likely to have been vaccinated on immunosuppressive therapy or after their diagnosis of IBD. CONCLUSIONS Most vaccinated patients with IBD maintain sustained seroprotection to HepB despite prolonged exposure to immunosuppression. This contradicts prior studies and shows that immunosuppression does not lead to loss of seroprotection.
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Affiliation(s)
- Dana Ley
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Sarah Lazarus
- Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - Amir Masound Forati
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Francis A Farraye
- Department of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic, Jacksonville, FL, USA
| | - Ryan Smith
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA.
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Smith RA, Desai A, Barnes EL, Hayney M, Kochhar GS, Hashash JG, Farraye FA, Caldera F. Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus. Am J Gastroenterol 2024; 119:1545-1554. [PMID: 38318981 DOI: 10.14309/ajg.0000000000002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Patients with inflammatory bowel disease (IBD) are at increased risk of developing respiratory infections. Respiratory syncytial virus (RSV) is a common respiratory virus with adverse outcomes in older adults. This study aimed to determine whether patients with IBD are at increased risk of a serious infection due to RSV. METHODS We conducted a retrospective study using the multi-institutional research network TriNetX to assess the risk of hospitalization in a cohort of patients with IBD compared with that in a non-IBD control cohort with RSV infection from January 1, 2007, to February 27, 2023. One-to-one (1:1) propensity score matching was performed for demographic variables and RSV risk factors between the 2 cohorts. Risk was expressed as adjusted odds ratio (aOR) with 95% confidence interval (CI). RESULTS There were 794 patients in the IBD-RSV cohort and 93,074 patients in the non-IBD-RSV cohort. The mean age of the IBD-RSV cohort was 55.6 ± 20 years, 59% were female, 80% were White, and 56.9% had Crohn's disease. The IBD-RSV cohort was at an increased risk of hospitalization (aOR 1.30, 95% CI 1.06-1.59). There was no difference in the risk (aOR 0.83, 95% CI 0.58-1.19) of a composite outcome of hospitalization-related complications between the 2 cohorts. Recent systemic corticosteroid use (<3 months) was associated with an increased risk of hospitalization (aOR 1.86, 95% CI 1.30-2.59) in the IBD-RSV cohort. DISCUSSION We found that adult patients with IBD and RSV infection are at an increased risk of hospitalization and may benefit from the new RSV vaccine recommended for adults aged 60 years and older.
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Affiliation(s)
- Ryan A Smith
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Aakash Desai
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Edward L Barnes
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mary Hayney
- School of Pharmacy, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Gursimran S Kochhar
- Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Jana G Hashash
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Francis A Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Bhat S, Lyu R, Agarwal M, Becker M, Bloomfeld R, Bruining DH, Cohen BL, Ivanov M, Leighton JA, Stewart AP, Trocke L, Tse SS, Ungaro RC, Vaughn BP, Regueiro M, Sokn E, Rieder F. Defining the Roles of Inflammatory Bowel Disease Clinical Pharmacists in the United States: A Systematic Review and National RAND/UCLA Consensus. Inflamm Bowel Dis 2024; 30:950-959. [PMID: 37650888 PMCID: PMC11145011 DOI: 10.1093/ibd/izad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Given the complexity of inflammatory bowel disease (IBD) care, utilization of multidisciplinary teams is recommended to optimize outcomes. There is a growing recognition that clinical pharmacists should be an integral part of this care model. We sought to define the roles of IBD clinical pharmacists in the United States. METHODS A national multidisciplinary expert panel of 12 gastroenterologists and clinical pharmacists practicing in IBD clinics was assembled. We used the RAND/University of California, Los Angeles appropriateness method, with a total of 281 statements generated based on a systematic literature review and expert opinion. Each statement was anonymously rated as appropriate, uncertain, or inappropriate in 2 rounds of voting. RESULTS The number of publications evaluating the clinical pharmacists' roles in IBD is limited, primarily focusing on thiopurine initiation and monitoring, medication adherence, and switching to biosimilars. Medication education; medication initiation and monitoring; therapeutic drug monitoring; biosimilar management; health maintenance review; and transitions of care were deemed by the panel to be appropriate roles for IBD clinical pharmacists. In considering real-world settings, IBD clinical pharmacists should practice clinically under a predefined scope and primarily focus on complex treatments (eg, immunomodulators, biologics, and small molecules). Clinical pharmacists should also be included in practice settings with IBD specialized physicians. Additionally, clinical pharmacists caring for patients with IBD should be residency trained and board certified. CONCLUSIONS This consensus defines IBD clinical pharmacists' roles and provides a framework for embedded clinical pharmacists in IBD care.
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Affiliation(s)
- Shubha Bhat
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Ruishen Lyu
- Department of Quantitative Health Science, Cleveland Clinic Foundation, OH, USA
| | - Mitali Agarwal
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | | | - Richard Bloomfeld
- Section of Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - David H Bruining
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Benjamin L Cohen
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Marina Ivanov
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Jonathan A Leighton
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Alyssa P Stewart
- Department of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Lindsay Trocke
- Department of Gastroenterology, M Health Fairview, Minneapolis, MN, USA
| | - Stacy S Tse
- Susan and Leonard Feinstein IBD Clinical Center, Mount Sinai Hospital, New York, NY, USA
| | - Ryan C Ungaro
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Byron P Vaughn
- Department of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Miguel Regueiro
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Erick Sokn
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Florian Rieder
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, OH, USA
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Karime C, Salazar M, Black CN, Caldera F, Okafor PN, Hammami MB, Hashash JG, Farraye FA. In Patients With Inflammatory Bowel Disease, Racial Disparities Exist in Burden of Vaccine-preventable Disease Hospitalizations and Outcomes. J Clin Gastroenterol 2024:00004836-990000000-00286. [PMID: 38619208 DOI: 10.1097/mcg.0000000000002005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Patients with inflammatory bowel disease (IBD) are at increased risk of vaccine-preventable diseases (VPDs). Despite the increasing prevalence of IBD in non-white populations, little is known regarding racial disparities in VPD burden. METHODS Retrospectively analyzing the 2016 to 2020 National Inpatient Sample, we identified adults with IBD hospitalized for a principal diagnosis of VPD. The primary outcome investigated was hospitalization for VPD stratified by patient-reported race. Secondary outcomes were in-hospital morbidity, mortality, length of stay, and health care utilization. Multivariable regression analysis was performed to adjust for patient and hospital characteristics. RESULTS The search identified 554,114 hospitalizations for VPD, including 4170 hospitalizations in patients with IBD. Patients with IBD had significantly greater odds of hospitalization from herpes zoster virus (adjusted odds ratio [aOR]: 1.73) and varicella zoster virus (aOR: 2.31). Comparing white and non-white patients with IBD, significant racial disparities were noted. Non-white patients were at greater odds of hospitalization from influenza (aOR: 1.74), herpes zoster virus (aOR: 1.77), and varicella zoster virus (aOR: 1.62). In-hospital morbidity was greater in non-white patients, including greater odds of requiring intensive care unit stay (aOR: 1.18). Morbidity was elevated in African Americans, with greater odds of acute kidney injury (aOR: 1.25), venous thromboembolism (aOR: 1.17), respiratory failure (aOR: 1.16), and intensive care unit stay (aOR: 1.18). No differences were found in mortality, length of stay, and health care utilization. CONCLUSIONS Significant racial disparities in VPD hospitalization and in-hospital morbidity were found among adults with IBD in the United States. With the increasing prevalence of IBD in non-white populations, targeted efforts are needed to improve health equity.
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Affiliation(s)
| | - Miguel Salazar
- Department of Gastroenterology and Hepatology, University of California, Riverside, CA
| | | | - Freddy Caldera
- Department of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Muhammad B Hammami
- Department of Gastroenterology and Hepatology, University of California, Riverside, CA
| | - Jana G Hashash
- Department of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic, Jacksonville, FL
| | - Francis A Farraye
- Department of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic, Jacksonville, FL
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Ye S, Li W, Yang J, Xue X, Chen J, Zhao W, Jiang L, Jia L. Erythropoietin inhibits neutrophil extracellular traps formation to ameliorate lung injury in a pneumonia model. Allergol Immunopathol (Madr) 2023; 51:60-66. [PMID: 37937497 DOI: 10.15586/aei.v51i6.980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/11/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Severe pneumonia is a kind of disease that develops from lung inflammation, and new drugs are still required to treat the same. Erythropoietin (EPO) is widely used to treat anemia in patients. However, there are fewer studies on the role of EPO in neutrophil extracellular trappings (NETs) and pneumonia, and the mechanism is unclear. OBJECTIVE To investigate the possible effects of EPO on the formation of NETs and progression of pneumonia. METHODS Mice pneumonia model was induced by tracheal lipopolysaccharide (LPS) administration. Hematoxylin and eosin (H&E) staining and automatic blood cell analysis were performed in this model to confirm the effects of EPO on lung injury. Flow cytometry, enzyme-linked immunosorbent serological assay, and immunostaining assay were conducted to detect the effects of EPO on the inflammation as well as formation of NETs in mice. Immunoblot was further conducted to confirm the mechanism. RESULTS EPO alleviated LPS-induced lung injury. EPO reduced the release of inflammatory factors induced by LPS. In addition, EPO inhibited the formation of NETs. Mechanically, EPO inhibited tumor necrosis factor (TNF) receptor associated factor 2 (TRAF2)/nuclear factor kappa-B (NF-κB) activity in mouse models, and therefore suppressed the progression of pneumonia. CONCLUSION EPO inhibited formation of NETs to ameliorate lung injury in a pneumonia model, and could serve as a drug of pneumonia.
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Affiliation(s)
- Sheng Ye
- Department of Respiratory and Critical Care Medicine, Nanjing BenQ Medical Center, the Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei Li
- Department of Critical Care Medicine, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Jinghui Yang
- Department of Intensive Care Unit, SIR RUN RUN Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Xiang Xue
- Department of Intensive Care Unit, SIR RUN RUN Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Jiao Chen
- Department of Intensive Care Unit, SIR RUN RUN Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei Zhao
- Department of Intensive Care Unit, SIR RUN RUN Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Lei Jiang
- Department of Emergency, the First Affiliated Hospital of Naval Medical University, Shanghai, China;
| | - Ling Jia
- Department of Intensive Care Unit, SIR RUN RUN Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China;
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Beniwal-Patel P, Waclawik G, Browning K, Urmat A, Schell TL, Smith R, Huerta A, Hipp L, Dave S, Shah N, Dillon KE, Reiter-Schreurs K, Russ RK, Mailig MA, Osman F, Farraye FA, Weiss J, Hayney MS, Caldera F. Racial, Ethnic, and Geographic Disparities in Immunization Rates Among Patients With Inflammatory Bowel Disease. CROHN'S & COLITIS 360 2023; 5:otad078. [PMID: 38130948 PMCID: PMC10734681 DOI: 10.1093/crocol/otad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims Racial and ethnic disparities exist in the treatment of IBD. These disparities exist in adult vaccine uptake among the general population and may extend to patients with IBD. The primary aim of this study was to determine whether racial, ethnic, or geographic disparities existed in influenza vaccine uptake among patients with IBD. Methods We performed a multicenter, retrospective cohort study evaluating adult vaccine uptake among patients with IBD seen at two tertiary referral centers between September 2019 and February 2020. The primary outcome was to determine if racial/ethnic and geographic disparities existed in influenza vaccine uptake for the two prior seasons. Our secondary outcomes were to determine if disparities existed for pneumococcal, zoster, or hepatitis B vaccines. Results Among the 2453 patients who met the inclusion criteria, most identified as non-Hispanic White (89.9%), were on immunosuppressive therapy (74.5%), and received the influenza vaccine in both seasons (56.0%). Older age (prevalence ratio (PR) 0.98; 95% confidence interval (95%CI) 0.98-0.99; P < .001) and non-Hispanic White patients (PR 0.76, 95%CI 0.59-0.98, P < 0.03) were significantly more likely to be immunized. Black patients (PR 1.37; 95%CI 1.18-1.59; P < .001) and those living in underserved geographic areas (PR 1.35; 95%CI 1.17-1.56; P < 0.001) were less likely to be immunized. Racial/ethnic and geographic disparities were identified for pneumococcal, zoster, and hepatitis B vaccine uptake. Conclusions Racial and ethnic vaccination uptake disparities exist among patients with IBD; patients from medically underserved areas are also vulnerable to these disparities Studies identifying patient, provider, and system-level opportunities to address these disparities are needed.
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Affiliation(s)
- Poonam Beniwal-Patel
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Gabrielle Waclawik
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Keely Browning
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Aijan Urmat
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Trevor L Schell
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Ryan Smith
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Antonio Huerta
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Lauren Hipp
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sonya Dave
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Neemit Shah
- Depatrment of Medicine, Medical College of Wisconsin School of Medicine, Milwaukee, WI, USA
| | - Kayla E Dillon
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Rachel K Russ
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Miguel A Mailig
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer Weiss
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
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Almasry M, Caldera F. Providing Pneumococcal Vaccines Reduces the Risk of Serious Infections From Pneumococcal Pneumonia. We Should Consider a Simplified Immunization Schedule. CROHN'S & COLITIS 360 2023; 5:otad056. [PMID: 37901190 PMCID: PMC10610748 DOI: 10.1093/crocol/otad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Affiliation(s)
- Mazen Almasry
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, University of Wisconsin–Madison School of Medicine and Public Health, Madison, WI, USA
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Almasry M, Caldera F. Taking a JAB at How Gastroenterologists Can Increase Vaccination Rates in Patients with Inflammatory Bowel Disease. Dig Dis Sci 2023:10.1007/s10620-023-07905-5. [PMID: 37024742 PMCID: PMC10079154 DOI: 10.1007/s10620-023-07905-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/24/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Mazen Almasry
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA.
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Using American College of Gastroenterology Guidelines to provide effective health maintenance for patients with inflammatory bowel disease. J Am Assoc Nurse Pract 2023; 35:86-92. [PMID: 36525528 DOI: 10.1097/jxx.0000000000000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) are at increased risk for infections, malignancies, and osteoporosis, related to both the disease state and medical therapy. Identification and treatment of depression and anxiety is crucial for disease management. Guidelines developed by the American College of Gastroenterology include recommendations for preventive health maintenance in patients with IBD to guide quality care. LOCAL PROBLEM Chart audits in a private gastroenterology practice revealed that only 20% of patients with IBD were receiving recommended health maintenance. The aim was to increase effective preventive care of patients with inflammatory bowel disease by 50% by the end of 8 weeks. METHODS The quality improvement project consisted of four rapid Plan-Do-Study-Act cycles. INTERVENTIONS The interventions implemented for this quality improvement project included a patient questionnaire, an order sheet/order set, a case management log, and team engagement. RESULTS Providers identified deficiencies and ordered needed health maintenance for 100% of patients with IBD. While effective preventive care orders increased, order completion rates were unchanged during the project. CONCLUSIONS Patient questionnaires, order sheets, a case management log, and teamwork were successfully used by providers in a private gastroenterology practice to increase orders placed for preventive care in patients with IBD. The project tools could easily be modified and implemented in other specialty practices who care for patients with specialized health maintenance needs.
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CED: hohe Krankheitslast durch impfpräventable Erkrankungen. ZEITSCHRIFT FÜR GASTROENTEROLOGIE 2023. [DOI: 10.1055/a-1942-3147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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12
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Crosby S, Schuh MJ, Becker M, Ivanov M, Caldera F, Farraye FA. New Pneumococcal Vaccines for Prevention of Invasive Pneumococcal Disease in Adult Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 29:661-664. [PMID: 35830419 DOI: 10.1093/ibd/izac150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Indexed: 04/05/2023]
Abstract
Patients with inflammatory bowel disease (IBD) are at a high risk of developing invasive pneumococcal infection both before and after they are diagnosed. The Advisory Committee on Immunization Practices now endorses use of 2 new pneumococcal conjugate vaccines, PCV15 (Vaxneuvance) and PCV20 (Prevnar 20), for patients who have never received a pneumococcal conjugate vaccine or those with unknown vaccination history. Previous studies have shown that pneumococcal vaccination can decrease the risk of developing severe pneumococcal disease; therefore, it is important that patients with IBD receive pneumococcal vaccination. This report aims to inform clinicians who care for patients with IBD about the changes in immunization practices, as it pertains to pneumococcal vaccination and provides appropriate direction on administering vaccination series.
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Affiliation(s)
- Sheena Crosby
- Department of Pharmacy, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Marina Ivanov
- Department of Pharmacy, Mayo Clinic, Scottsdale, AZ, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
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