VA Study: Anemia Often Overlooked in IBD Patients

by U.S. Medicine

June 26, 2019

HOUSTON—Anemia is a common complication of inflammatory bowel disease, and existing guidelines urge vigilance for the condition.

Yet, according to a study in Digestive Diseases & Sciences, it is frequently undertreated, resulting in the prevalence remaining high.1

To address the care gap, the Crohn’s and Colitis Foundation developed the Anemia Care Pathway. A study led by researchers from the Michael E. DeBakey VAMC sought to implement the ACP in a managed-care setting and identify where it improves practice habits. Researchers also sought to identify where barriers remain.

The ACP was implemented from July 2016 through June 2017 and retrospectively studied. The study team used run charts to identify shifts in iron deficiency screening and treatment, as well as anemia prevalence. The team also compared their results to those of other providers in the same center not using the ACP.

With 640 IBD encounters studied, 213 anemia patients in the ACP clinic received iron therapy in only 30% of encounters at baseline, although that improved to 80%. At the same time, anemia prevalence decreased from 48% to 25%. 

No improvement for screening for iron deficiency was documented, however. In addition, no changes were seen in the 427 patients at the clinics who had not adopted the ACP guidelines, even though clinicians were aware of the changes.

“Across 1 year, we observed gaps in the screening and treatment of anemia in IBD,” the study authors concluded. “Although screening rates did not improve, the ACP appeared to reduce missed opportunities for iron therapy by about half. Most importantly, this was associated with an overall decrease in anemia prevalence. Future refinements to the ACP should be focused on enhanced screening and follow-up.”

Qureshi T, Peter Nguyen T, Wang R, Willis D, Shah R, Hou JK. Improving Anemia in Inflammatory Bowel Disease: Impact of the Anemia Care Pathway. Dig Dis Sci.2019 Mar 16. doi: 10.1007/s10620-019-05559-w. [Epub ahead of print] PubMed PMID: 30879168.

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