Overview on the management of diverticular disease by Italian General Practitioners.
Adult
Age Distribution
Aged
Anti-Bacterial Agents
/ therapeutic use
Comorbidity
Cross-Sectional Studies
Databases, Factual
Diverticulitis, Colonic
/ classification
Female
Gastrointestinal Agents
/ therapeutic use
General Practice
/ methods
Hospitalization
/ statistics & numerical data
Humans
Italy
/ epidemiology
Male
Middle Aged
Prevalence
Risk Factors
Diverticulosis
Family medicine
Mesalazine
Rifaximin
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
15
04
2018
revised:
17
07
2018
accepted:
19
07
2018
pubmed:
26
8
2018
medline:
14
6
2019
entrez:
26
8
2018
Statut:
ppublish
Résumé
Although very common in Western countries, poor epidemiological data on diverticular disease (DD) is available from the family practice. To evaluate the behavior of Italian General Practitioners (GPs) on approaching DD. Health Search Database was analyzed retrospectively. On a population of 975,523 individuals, 33,597 patients had a registered diagnosis of DD ("lifetime" prevalence = 3.4%, M = 3.2%, F = 3.7%; higher values are found in females over-65 years old; low rates of complications: diverticulitis = 0.3%, bleeding = 0.002%). As risk factors, NSAIDs and ASA were taken by 14.8% and 26.5% respectively, opioids by 7.5%, corticosteroids by 5.2%; as protective factors, 30.4% were under statins and 17.7% under calcium-antagonists. Approximately 13% of patients were referred to specialists. Colonoscopy and abdominal CT were prescribed to 48.5% and to 13% of already diagnosed patients. Among DD sufferers, 27% experienced hospitalization, but only 3.4% of cases were for a DD-linked problem. Treatment included rifaximin (61%), mesalazine (14.7%), probiotics (12.4%), ciprofloxacin (7.6%). DD has a large impact in general practice with a higher prevalence in the elderly. GPs are required to pay particular attention to risk factors both for disease development and for its complications in order to reduce the costs deriving from diagnostic procedures, referral and hospitalization.
Sections du résumé
BACKGROUND
Although very common in Western countries, poor epidemiological data on diverticular disease (DD) is available from the family practice.
AIMS
To evaluate the behavior of Italian General Practitioners (GPs) on approaching DD.
METHODS
Health Search Database was analyzed retrospectively.
RESULTS
On a population of 975,523 individuals, 33,597 patients had a registered diagnosis of DD ("lifetime" prevalence = 3.4%, M = 3.2%, F = 3.7%; higher values are found in females over-65 years old; low rates of complications: diverticulitis = 0.3%, bleeding = 0.002%). As risk factors, NSAIDs and ASA were taken by 14.8% and 26.5% respectively, opioids by 7.5%, corticosteroids by 5.2%; as protective factors, 30.4% were under statins and 17.7% under calcium-antagonists. Approximately 13% of patients were referred to specialists. Colonoscopy and abdominal CT were prescribed to 48.5% and to 13% of already diagnosed patients. Among DD sufferers, 27% experienced hospitalization, but only 3.4% of cases were for a DD-linked problem. Treatment included rifaximin (61%), mesalazine (14.7%), probiotics (12.4%), ciprofloxacin (7.6%).
CONCLUSION
DD has a large impact in general practice with a higher prevalence in the elderly. GPs are required to pay particular attention to risk factors both for disease development and for its complications in order to reduce the costs deriving from diagnostic procedures, referral and hospitalization.
Identifiants
pubmed: 30143468
pii: S1590-8658(18)30846-6
doi: 10.1016/j.dld.2018.07.015
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Gastrointestinal Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-67Informations de copyright
Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.