Abstract
OBJECTIVES: Practice guidelines should improve care, but they are not routinely followed, in part because of lack of proven benefit. We evaluated the effect of introducing guidelines for inflammatory bowel disease (IBD) on practice variation and the IBD Quality of Life (IBDQ) score. METHODS: This was a prospective, controlled, cohort study. A total of 65 patients were matched according to month of visit, diagnosis, and disease activity with control subjects seen I yr earlier. Physicians were educated throughout the study regarding the guidelines. Variation was measured by the Mayo Practice Guideline Score (MPGS), a 15-point assessment of documentation of diagnosis, nutrition, social support, education, functional status, and treatment. The IBDQ was measured at baseline and at 1 yr in the intervention group and after 1 yr in the control group. RESULTS: The MPGS was significantly higher in the intervention group compared to the controls (p = 0.002), with median values of 12 versus 11. The IBDQ median score increased significantly in the intervention group (p < 0.001), baseline median of 133 versus 15-month median of 184. However, the final IBDQ was not significantly higher in the intervention group than in the controls (p = 0.33). CONCLUSIONS: Practice guidelines for IBD reduce practice variation. The quality of life improved significantly compared to baseline with practice guidelines, but not compared to controls, perhaps because of the small sample size and homogenous practice setting. The MPGS is a tool that can be used in day-to-day management of IBD patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2401-2406 |
| Number of pages | 6 |
| Journal | American Journal of Gastroenterology |
| Volume | 96 |
| Issue number | 8 |
| DOIs | |
| State | Published - 2001 |
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ASJC Scopus subject areas
- Gastroenterology
Cite this
A prospective cohort study of practice guidelines in inflammatory bowel disease. / Tremaine, William J.; Sandborn, William J.; Loftus, Jr, Edward Vincent; Kenan, Margaret L.; Petterson, Tanya M.; Zinsmeister, Alan R.; Silverstein, Marc D.
In: American Journal of Gastroenterology, Vol. 96, No. 8, 2001, p. 2401-2406.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A prospective cohort study of practice guidelines in inflammatory bowel disease
AU - Tremaine, William J.
AU - Sandborn, William J.
AU - Loftus, Jr, Edward Vincent
AU - Kenan, Margaret L.
AU - Petterson, Tanya M.
AU - Zinsmeister, Alan R.
AU - Silverstein, Marc D.
PY - 2001
Y1 - 2001
N2 - OBJECTIVES: Practice guidelines should improve care, but they are not routinely followed, in part because of lack of proven benefit. We evaluated the effect of introducing guidelines for inflammatory bowel disease (IBD) on practice variation and the IBD Quality of Life (IBDQ) score. METHODS: This was a prospective, controlled, cohort study. A total of 65 patients were matched according to month of visit, diagnosis, and disease activity with control subjects seen I yr earlier. Physicians were educated throughout the study regarding the guidelines. Variation was measured by the Mayo Practice Guideline Score (MPGS), a 15-point assessment of documentation of diagnosis, nutrition, social support, education, functional status, and treatment. The IBDQ was measured at baseline and at 1 yr in the intervention group and after 1 yr in the control group. RESULTS: The MPGS was significantly higher in the intervention group compared to the controls (p = 0.002), with median values of 12 versus 11. The IBDQ median score increased significantly in the intervention group (p < 0.001), baseline median of 133 versus 15-month median of 184. However, the final IBDQ was not significantly higher in the intervention group than in the controls (p = 0.33). CONCLUSIONS: Practice guidelines for IBD reduce practice variation. The quality of life improved significantly compared to baseline with practice guidelines, but not compared to controls, perhaps because of the small sample size and homogenous practice setting. The MPGS is a tool that can be used in day-to-day management of IBD patients.
AB - OBJECTIVES: Practice guidelines should improve care, but they are not routinely followed, in part because of lack of proven benefit. We evaluated the effect of introducing guidelines for inflammatory bowel disease (IBD) on practice variation and the IBD Quality of Life (IBDQ) score. METHODS: This was a prospective, controlled, cohort study. A total of 65 patients were matched according to month of visit, diagnosis, and disease activity with control subjects seen I yr earlier. Physicians were educated throughout the study regarding the guidelines. Variation was measured by the Mayo Practice Guideline Score (MPGS), a 15-point assessment of documentation of diagnosis, nutrition, social support, education, functional status, and treatment. The IBDQ was measured at baseline and at 1 yr in the intervention group and after 1 yr in the control group. RESULTS: The MPGS was significantly higher in the intervention group compared to the controls (p = 0.002), with median values of 12 versus 11. The IBDQ median score increased significantly in the intervention group (p < 0.001), baseline median of 133 versus 15-month median of 184. However, the final IBDQ was not significantly higher in the intervention group than in the controls (p = 0.33). CONCLUSIONS: Practice guidelines for IBD reduce practice variation. The quality of life improved significantly compared to baseline with practice guidelines, but not compared to controls, perhaps because of the small sample size and homogenous practice setting. The MPGS is a tool that can be used in day-to-day management of IBD patients.
UR - http://www.scopus.com/inward/record.url?scp=0034891074&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034891074&partnerID=8YFLogxK
U2 - 10.1016/S0002-9270(01)02605-3
DO - 10.1016/S0002-9270(01)02605-3
M3 - Article
C2 - 11513181
AN - SCOPUS:0034891074
VL - 96
SP - 2401
EP - 2406
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 8
ER -