Inadequate Anemia Testing for UC Patients at VA

by U.S. Medicine

December 5, 2016

PHILADELPHIA—Many veterans being treated at the VA for ulcerative colitis aren’t getting recommended testing and treatment for the common problem of iron deficiency anemia.

That’s according to a new report in the journal Inflammatory Bowel Diseases. The study, conducted by University of Pennsylvania Perelman School of Medicine and colleagues, notes that about one-third of ulcerative colitis patients with anemia are not tested for iron deficiency and that nearly one-fourth of those diagnosed with iron deficiency anemia don’t receive iron replacement therapy.1

“Our study emphasizes the need to educate gastroenterologists and general practitioners to diagnose and treat iron deficiency anemia at an early stage,” the researchers wrote.

Used in the study was nationwide data on 836 patients newly diagnosed with ulcerative colitis at the VA from 2001 to 2011. Over a median eight years’ follow-up, 70% of patients developed anemia.

Researchers sought to determine how many of these patients were tested and treated for iron deficiency anemia, which is a common complication of ulcerative colitis, caused by intestinal bleeding and malnutrition. Iron deficiency anemia has profound effects on health, including declines in physical and cognitive abilities, according to background information in the study.

The results indicated “inadequate monitoring and treatment of anemia and iron deficiency” among patients with ulcerative colitis. Of the patients who developed anemia, 31% did not undergo recommended tests for iron deficiency, according to the report, which noted that 63% of patients tested were diagnosed with iron deficiency anemia.

Overall, according to the report, about one-fourth of patients remain untreated, despite testing and diagnosis. In addition, all of the treated patients received oral iron supplements, even those with severe anemia, for which intravenous iron supplementation is the preferred treatment.

Testing for iron deficiency anemia was less likely for patients in the Midwest and South regions, compared to the Northeast and West—possibly reflecting differences in physician awareness or patient follow-up care.

“Testing and treatment are both easily measurable parameters, and emphasizing their importance will lead to better patient outcomes,” study authors concluded.

Khan N, Patel D, Shah Y, Yang YX. Factors Predicting Testing and Treatment of Iron Deficiency in a Nationwide Cohort of Anemic UC Patients. Inflamm Bowel Dis. 2016 Oct 18. [Epub ahead of print] PubMed PMID: 27763952.


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