Network Approach Improves Outcomes for Crohn’s and UC

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BURLINGTON, Vt.—Many children with Crohn’s disease and ulcerative colitis who received treatment through ImproveCareNow, a Vermont-based national quality-improvement and research network, ceased to have symptoms and no longer needed to take steroids for disease management. These are the findings from a study appearing in Pediatrics that examined the ImproveCareNow network’s quality improvement efforts and their impact on outcomes. In this study, the proportion of children with Crohn’s disease who were in remission increased from 55 percent to 68 percent, with a similar improvement in ulcerative colitis patients.

Crohn’s disease and ulcerative colitis, also called inflammatory bowel disease (IBD), are gastrointestinal disorders that lead to intestinal inflammation as a result of an overactive immune reaction. Despite therapeutic advances in the treatment of pediatric IBD, there has been limited improvement in outcomes over the last several decades.

“IBD management varies greatly throughout the country due to a lack of consensus on best practices and inadequate care delivery systems," said study author Wallace Crandall, MD, director of the Center for Pediatric and Adolescent Inflammatory Bowel Disease at Nationwide Children’s Hospital, and ImproveCareNow physician leader. “Nationally, IBD patients receive differing diagnostic, treatment and nutritional interventions, suboptimal medication dosages, prolonged prescription of corticosteroids, and fail to receive steroid-sparing agents."

The ImproveCareNow Network was formed in 2007 to improve the care and outcomes of children with Crohn’s disease and ulcerative colitis. It has grown to include 33 centers with 300 gastroenterologists and 10,000 patients. The network developed a set of recommendations to standardize diagnosis and treatment, classify disease severity and evaluate nutritional and growth status. Participating centers implemented these standards for their IBD patients.

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