Italian College of General Practitioners and Primary Care, Florence, Italy.
Italian College of General Practitioners and Primary Care, Florence, Italy.
Dig Liver Dis. 2019 Jan;51(1):63-67. doi: 10.1016/j.dld.2018.07.015. Epub 2018 Jul 31.
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.
尽管在西方国家中非常常见，但家庭医生对憩室疾病（DD）的流行病学数据很少。
评估意大利全科医生（GP）处理 DD 的行为。
回顾性分析 Health Search 数据库。
在 975,523 名个体中，有 33,597 名患者有 DD 的注册诊断（“终身”患病率为 3.4%，M=3.2%，F=3.7%；在 65 岁以上的女性中发现更高的值；并发症发生率较低：憩室炎为 0.3%，出血为 0.002%）。作为危险因素，分别有 14.8%和 26.5%的患者服用 NSAIDs 和 ASA，7.5%的患者服用阿片类药物，5.2%的患者服用皮质类固醇；作为保护因素，30.4%的患者服用他汀类药物，17.7%的患者服用钙拮抗剂。约有 13%的患者被转介给专科医生。对已经诊断出的患者，48.5%的患者进行了结肠镜检查，13%的患者进行了腹部 CT 检查。在 DD 患者中，有 27%的患者住院，但只有 3.4%的患者是因 DD 相关问题住院。治疗包括利福昔明（61%）、美沙拉嗪（14.7%）、益生菌（12.4%）、环丙沙星（7.6%）。
DD 在全科医疗中有很大的影响，在老年人中更为常见。GP 需要特别注意疾病发展和并发症的危险因素，以降低诊断程序、转诊和住院的费用。
