Herrinton LJ, Liu L, Fireman B et al. Gastroenterology 2009;137:502–11.
Time trends and differences across medical centers in the care for adult IBD patients were investigated in this analysis. From 1998 to 2005, there was a reduction in prolonged steroid use and hospitalization in Crohn’s disease, but the rate of surgery remained constant. In ulcerative colitis, the results were also mixed with increased prolonged steroid use but reduced hospitalizations and surgeries. Over time, there was a shift in care from gastroenterologists toward primary care physicians.
This study involved 2892 subjects with Crohn’s disease and 5895 subjects with ulcerative colitis (UC) who attended one of 16 clinics that are part of the Kaiser Permanente health maintenance organization in Northern California, USA, between 1998 and 2005. Of the Crohn’s disease patients, 77% were white, while 67% of the UC patients were white. Of the total population, 63% were <50 years of age. There was a slight female predominance in the Crohn’s disease group with an equal sex ratio in UC.