Factors associated with more frequent diagnostic tests and procedures in patients with irritable bowel syndrome.
claims analysis
diagnostic tests
irritable bowel syndrome
procedures resource use
Journal
Therapeutic advances in gastroenterology
ISSN: 1756-283X
Titre abrégé: Therap Adv Gastroenterol
Pays: England
ID NLM: 101478893
Informations de publication
Date de publication:
2019
2019
Historique:
received:
28
02
2018
accepted:
26
10
2018
entrez:
15
1
2019
pubmed:
15
1
2019
medline:
15
1
2019
Statut:
epublish
Résumé
Irritable bowel syndrome (IBS) reduces quality of life and burdens healthcare systems. This study identified factors associated with frequent use of IBS diagnostic tests and procedures. Using a United States claims database (2001-2012), tests and procedures in IBS patients occurring in the 2-year study period (12 months before/following the first IBS diagnosis) were analyzed: endoscopy, GI transit testing, anorectal procedures, and radiologic imaging. Patients were classified based on test/procedure frequency (3+, 1-2, or 0). Multivariate logistic regression identified factors associated with more frequent tests/procedures. Among 201,322 IBS patients, 41.7% had 3+ tests/procedures, 35.1% had 1-2, and 23.3% had 0. Patients with more tests/procedures were older [mean age 50.6 (3+ group), more likely to be female and had more comorbidities, including anxiety, depressive disorders, and somatization. Dyspepsia [odds ratio (95% confidence interval): 1.80 (1.72-1.87)], interstitial cystitis [1.60 (1.45-1.77)], gastroesophageal reflux disease [1.59 (1.55-1.63)], constipation [1.50 (1.45-1.54)], and dyspareunia [1.38 (1.25-1.52)] were significantly associated with more tests/procedures (3+ Test frequency in patients with IBS is strongly associated with demographic and clinical characteristics, especially comorbid conditions related to IBS. Presence of common overlapping comorbid conditions should increase clinicians' confidence in making the diagnosis of IBS, thus curtailing redundant testing and reducing healthcare costs.
Sections du résumé
BACKGROUND
BACKGROUND
Irritable bowel syndrome (IBS) reduces quality of life and burdens healthcare systems. This study identified factors associated with frequent use of IBS diagnostic tests and procedures.
METHODS
METHODS
Using a United States claims database (2001-2012), tests and procedures in IBS patients occurring in the 2-year study period (12 months before/following the first IBS diagnosis) were analyzed: endoscopy, GI transit testing, anorectal procedures, and radiologic imaging. Patients were classified based on test/procedure frequency (3+, 1-2, or 0). Multivariate logistic regression identified factors associated with more frequent tests/procedures.
RESULTS
RESULTS
Among 201,322 IBS patients, 41.7% had 3+ tests/procedures, 35.1% had 1-2, and 23.3% had 0. Patients with more tests/procedures were older [mean age 50.6 (3+ group), more likely to be female and had more comorbidities, including anxiety, depressive disorders, and somatization. Dyspepsia [odds ratio (95% confidence interval): 1.80 (1.72-1.87)], interstitial cystitis [1.60 (1.45-1.77)], gastroesophageal reflux disease [1.59 (1.55-1.63)], constipation [1.50 (1.45-1.54)], and dyspareunia [1.38 (1.25-1.52)] were significantly associated with more tests/procedures (3+
CONCLUSIONS
CONCLUSIONS
Test frequency in patients with IBS is strongly associated with demographic and clinical characteristics, especially comorbid conditions related to IBS. Presence of common overlapping comorbid conditions should increase clinicians' confidence in making the diagnosis of IBS, thus curtailing redundant testing and reducing healthcare costs.
Identifiants
pubmed: 30636972
doi: 10.1177/1756284818818326
pii: 10.1177_1756284818818326
pmc: PMC6317153
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1756284818818326Déclaration de conflit d'intérêts
Conflict of interest statement: BL is a scientific advisory board member with Takeda Pharmaceuticals, Ironwood, and Salix. RA, AG, and SS are employees of Analysis Group, Inc., and AL is a former employee of Analysis Group, Inc., which has received consultancy fees from Takeda Pharmaceuticals. ML is an employee of Takeda Pharmaceuticals and owns stock/stock options.
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