A prospective cohort study of practice guidelines in inflammatory bowel disease

William J. Tremaine, William J. Sandborn, Edward Vincent Loftus, Jr, Margaret L. Kenan, Tanya M. Petterson, Alan R. Zinsmeister, Marc D. Silverstein

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)2401-2406
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume96
Issue number8
DOIs
StatePublished - 2001

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Inflammatory Bowel Diseases
Practice Guidelines
Cohort Studies
Prospective Studies
Quality of Life
Guidelines
Control Groups
Social Support
Documentation
Sample Size
Physicians
Education

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Tremaine, W. J., Sandborn, W. J., Loftus, Jr, E. V., Kenan, M. L., Petterson, T. M., Zinsmeister, A. R., & Silverstein, M. D. (2001). A prospective cohort study of practice guidelines in inflammatory bowel disease. American Journal of Gastroenterology, 96(8), 2401-2406. https://doi.org/10.1016/S0002-9270(01)02605-3

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 journalArticle

Tremaine, WJ, Sandborn, WJ, Loftus, Jr, EV, Kenan, ML, Petterson, TM, Zinsmeister, AR & Silverstein, MD 2001, 'A prospective cohort study of practice guidelines in inflammatory bowel disease', American Journal of Gastroenterology, vol. 96, no. 8, pp. 2401-2406. https://doi.org/10.1016/S0002-9270(01)02605-3
Tremaine, William J. ; Sandborn, William J. ; Loftus, Jr, Edward Vincent ; Kenan, Margaret L. ; Petterson, Tanya M. ; Zinsmeister, Alan R. ; Silverstein, Marc D. / A prospective cohort study of practice guidelines in inflammatory bowel disease. In: American Journal of Gastroenterology. 2001 ; Vol. 96, No. 8. pp. 2401-2406.
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