Department of Gastroenterology, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.
School of Immunology and Microbial Sciences, King's College London, London, UK.
Evid Based Ment Health. 2021 May;24(2):82-87. doi: 10.1136/ebmental-2020-300167. Epub 2020 Sep 17.
People with inflammatory bowel disease (IBD) are at increased risk of pneumonia and herpes zoster, yet other common infection types have not been explored. Anxiety and depression are more prevalent in IBD; however, the impact of these conditions on primary care healthcare use in IBD is not known.
We will perform two retrospective studies using a large English population-based primary care cohort to compare the following outcomes in people with IBD and matched controls: incident infections (Study 1) and prevalent mental health problems and healthcare use, overall and in those with and without mental health problems (Study 2). All adults registered with general practices contributing to Royal College of General Practitioners Research and Surveillance Centre database between 1 January 2014 and 1 January 2019 are eligible. Infection outcomes comprise the incidence of common infections (upper respiratory tract infections, pneumonia, acute bronchitis, influenza and influenza-like illnesses, skin infections, herpes simplex and herpes zoster infections, genital infections, urinary tract infections and gastrointestinal infections) and any viral infection. Mental health and healthcare use outcomes are: prevalence of depressive episodes; anxiety episodes; recurrent depression; rates of primary care and emergency secondary care visits; primary-care issued sick notes (reflecting time off work). Analyses will be adjusted for sociodemographic factors recorded in the primary care record.
These studies will quantify the infection risk in IBD, the excess burden of anxiety and depression in a population-based IBD cohort, and the impact of mental health conditions on healthcare use and time off work. Greater understanding and awareness of infection risk and common mental health issues will benefit people with IBD and healthcare practitioners and will guide policy makers as allocation of resource may be guided by the real-world information produced by these studies.
NCT03836612.
患有炎症性肠病（IBD）的人患肺炎和带状疱疹的风险增加，但其他常见感染类型尚未得到研究。焦虑和抑郁在 IBD 中更为普遍；然而，这些疾病对 IBD 初级保健医疗使用的影响尚不清楚。
我们将使用一个大型的英语人群为基础的初级保健队列进行两项回顾性研究，以比较 IBD 患者和匹配对照者的以下结果：感染事件（研究 1）以及普遍存在的心理健康问题和整体医疗使用，以及那些有和没有心理健康问题的人的医疗使用（研究 2）。所有在 2014 年 1 月 1 日至 2019 年 1 月 1 日期间注册参与皇家全科医生研究和监测中心数据库的普通实践的成年人都有资格参加。感染结果包括常见感染（上呼吸道感染、肺炎、急性支气管炎、流感和流感样疾病、皮肤感染、单纯疱疹和带状疱疹感染、生殖器感染、尿路感染和胃肠道感染）和任何病毒感染的发生率。心理健康和医疗使用结果包括：抑郁发作的患病率；焦虑发作；复发性抑郁；初级保健和急诊二级保健就诊率；初级保健开具的病假条（反映旷工时间）。分析将根据初级保健记录中记录的社会人口因素进行调整。
这些研究将量化 IBD 的感染风险、基于人群的 IBD 队列中焦虑和抑郁的过度负担，以及心理健康状况对医疗使用和旷工时间的影响。对感染风险和常见心理健康问题的更多了解和认识将使 IBD 患者和医疗保健从业者受益，并将指导政策制定者，因为资源的分配可能会受到这些研究产生的实际信息的指导。
NCT03836612。
