PMID- 30746632
OWN - NLM
STAT- Publisher
LR  - 20190212
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
DP  - 2019 Feb 12
TI  - Personalized Inflammatory Bowel Disease Care Reduced Hospitalizations.
LID - 10.1007/s10620-019-05485-x [doi]
AB  - BACKGROUND AND AIMS: IBD patients with inadequately treated disease often relapse
      and require hospitalizations for further management. The purpose of this practice
      review was to determine whether personalized IBD care improved patient outcomes
      as measured by IBD-related hospitalizations. METHODS: A dedicated IBD clinic was 
      created for personalized patient care in a tertiary veterans health care center
      in 2014. In the first year, the care program consisted of patient-centered
      medical home (PCMH). In the second year, personalized biologic therapy was
      incorporated into the program, based on the severity of mucosal barrier
      dysfunction measured by probe-based confocal laser endomicroscopy (pCLE) analysis
      of the terminal ileum during colonoscopy. IBD-related hospitalizations during
      these 2 years were compared to the year before the care program. RESULTS: The
      IBD-related admissions at baseline, year 1 and 2 of the program were: total
      number of admissions of 25, 24, 8 (P = 0.03) per year, total number of hospital
      days of 177, 144, 31 days per year (P < 0.01), median length of stay 7, 4, and 2 
      days per visit (P = 0.013), respectively. Patients had significant increases in
      serum hemoglobin (11.5 +/- 2.7, 11.9 +/- 2.6, 14.0 +/- 1.4 g/dl; P = 0.035),
      albumin (2.7 +/- 0.7, 3.0 +/- 0.6 g/dl 3.7 +/- 0.8 g/dl; P = 0.031) and body mass
      index (26.6 +/- 2.9, 28.1 +/- 5.9; 34.0 +/- 10.8; P = 0.047). CONCLUSIONS:
      Personalized IBD care incorporating a PCMH model and tailored biologic therapy
      based on pCLE findings of mucosal barrier dysfunction significantly reduced
      IBD-related hospitalizations.
FAU - Liu, Julia J
AU  - Liu JJ
AUID- ORCID: http://orcid.org/0000-0002-1267-7452
AD  - Department of Medicine, Central Arkansas Veterans Healthcare System, Little Rock,
      AR, USA. jjliu@uams.edu.
AD  - Division of Gastroenterology, University of Arkansas for Medical Sciences, Little
      Rock, AR, USA. jjliu@uams.edu.
FAU - Rosson, Thomas Brent
AU  - Rosson TB
AD  - Department of Medicine, Central Arkansas Veterans Healthcare System, Little Rock,
      AR, USA.
FAU - Xie, Jesse J
AU  - Xie JJ
AD  - Department of Medicine, Central Arkansas Veterans Healthcare System, Little Rock,
      AR, USA.
AD  - Division of Gastroenterology, University of Arkansas for Medical Sciences, Little
      Rock, AR, USA.
FAU - Harris, Zachary P
AU  - Harris ZP
AD  - Department of Medicine, Central Arkansas Veterans Healthcare System, Little Rock,
      AR, USA.
AD  - Division of Gastroenterology, University of Arkansas for Medical Sciences, Little
      Rock, AR, USA.
FAU - McBride, Regina G
AU  - McBride RG
AD  - Department of Nursing, Central Arkansas Veterans Healthcare Systems, Little Rock,
      AR, USA.
FAU - Siegel, Eric
AU  - Siegel E
AD  - Department of Biostatistics, University of Arkansas for Medical Sciences, Little 
      Rock, AR, USA.
FAU - Hagedorn, Curt
AU  - Hagedorn C
AD  - Department of Medicine, Central Arkansas Veterans Healthcare System, Little Rock,
      AR, USA.
AD  - Division of Gastroenterology, University of Arkansas for Medical Sciences, Little
      Rock, AR, USA.
LA  - eng
PT  - Journal Article
DEP - 20190212
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
OTO - NOTNLM
OT  - Confocal laser endomicroscopy
OT  - Hospitalization
OT  - Inflammatory bowel disease
OT  - Medical home
OT  - Personalized medicine
EDAT- 2019/02/13 06:00
MHDA- 2019/02/13 06:00
CRDT- 2019/02/13 06:00
PHST- 2018/06/22 00:00 [received]
PHST- 2019/01/22 00:00 [accepted]
PHST- 2019/02/13 06:00 [entrez]
PHST- 2019/02/13 06:00 [pubmed]
PHST- 2019/02/13 06:00 [medline]
AID - 10.1007/s10620-019-05485-x [doi]
AID - 10.1007/s10620-019-05485-x [pii]
PST - aheadofprint
SO  - Dig Dis Sci. 2019 Feb 12. pii: 10.1007/s10620-019-05485-x. doi:
      10.1007/s10620-019-05485-x.