Declining Rates of Referral for Irritable Bowel Syndrome Without Constipation at a Tertiary Care Center.
Adult
Aged
Drug Utilization Review
/ trends
Female
Gastrointestinal Agents
/ therapeutic use
Humans
Irritable Bowel Syndrome
/ diagnosis
Los Angeles
/ epidemiology
Male
Middle Aged
Practice Patterns, Physicians'
/ trends
Referral and Consultation
/ trends
Retrospective Studies
Rifaximin
/ therapeutic use
Tertiary Care Centers
/ trends
Time Factors
Treatment Outcome
Constipation
Diarrhea
Irritable bowel syndrome
Referral rates
Rifaximin
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
17
04
2018
accepted:
24
09
2018
pubmed:
17
10
2018
medline:
5
2
2019
entrez:
17
10
2018
Statut:
ppublish
Résumé
Irritable bowel syndrome (IBS) is a common chronic disorder of the gastrointestinal tract. Several treatments have been developed, including rifaximin for the treatment of IBS without constipation (non-IBS-C), but no studies have evaluated the effect of these therapies on patient referral rates to tertiary care gastroenterology clinics. To assess referral patterns for IBS patients at a tertiary motility clinic over a 10-year period. Data from consecutive patients referred to the clinic during 2006-2016 were analyzed. Trends in the proportion of referrals and prior rifaximin use in IBS-C versus non-IBS-C groups were compared. A total of 814 adult patients were referred to a single physician panel for IBS-related symptoms. Of these, 776 were included in the study [528 females (68%), average age 45.7 ± 15.9 years), comprising 431 IBS-C (55.5%) and 345 non-IBS-C (44.5%) patients. The proportion of non-IBS-C referrals declined significantly from 53.0% in 2006 to 27.3% in 2016 (Chi-square, p < 0.0001, Cochran-Armitage trend test p = 0.0001), and the proportion of IBS-C referrals increased significantly from 46.9% in 2006 to 72.7% in 2016 (Chi-square, p < 0.0001, Cochran-Armitage trend test p = 0.0004). Non-IBS-C referrals with prior rifaximin use significantly increased from 22.7% in 2006 to 66.7% in 2016 (Cochran-Armitage trend test, p = 0.008). The results indicate a significantly declining tertiary care referral rate for non-IBS-C over the past decade. While not directly linked, there has been an increase in rifaximin use in the same population during the same time interval.
Sections du résumé
BACKGROUND
Irritable bowel syndrome (IBS) is a common chronic disorder of the gastrointestinal tract. Several treatments have been developed, including rifaximin for the treatment of IBS without constipation (non-IBS-C), but no studies have evaluated the effect of these therapies on patient referral rates to tertiary care gastroenterology clinics.
AIM
To assess referral patterns for IBS patients at a tertiary motility clinic over a 10-year period.
METHODS
Data from consecutive patients referred to the clinic during 2006-2016 were analyzed. Trends in the proportion of referrals and prior rifaximin use in IBS-C versus non-IBS-C groups were compared.
RESULTS
A total of 814 adult patients were referred to a single physician panel for IBS-related symptoms. Of these, 776 were included in the study [528 females (68%), average age 45.7 ± 15.9 years), comprising 431 IBS-C (55.5%) and 345 non-IBS-C (44.5%) patients. The proportion of non-IBS-C referrals declined significantly from 53.0% in 2006 to 27.3% in 2016 (Chi-square, p < 0.0001, Cochran-Armitage trend test p = 0.0001), and the proportion of IBS-C referrals increased significantly from 46.9% in 2006 to 72.7% in 2016 (Chi-square, p < 0.0001, Cochran-Armitage trend test p = 0.0004). Non-IBS-C referrals with prior rifaximin use significantly increased from 22.7% in 2006 to 66.7% in 2016 (Cochran-Armitage trend test, p = 0.008).
CONCLUSIONS
The results indicate a significantly declining tertiary care referral rate for non-IBS-C over the past decade. While not directly linked, there has been an increase in rifaximin use in the same population during the same time interval.
Identifiants
pubmed: 30324554
doi: 10.1007/s10620-018-5302-2
pii: 10.1007/s10620-018-5302-2
doi:
Substances chimiques
Gastrointestinal Agents
0
Rifaximin
L36O5T016N
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
182-188Références
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