Smith Jennifer, Jacobson-Kelly Amanda, Donegan Amy, Boyle Brendan, Maltz Ross M, Michel Hilary K, Dotson Jennifer L
From the Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH.
the Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH.
J Pediatr Gastroenterol Nutr. 2023 Mar 1;76(3):313-318. doi: 10.1097/MPG.0000000000003673. Epub 2022 Nov 30.
Iron deficiency (ID) with and without anemia is prevalent in children and adults diagnosed with inflammatory bowel disease (IBD), but often goes unrecognized. We hypothesized, quality improvement (QI) methodology could increase the screening for and treatment of ID in children newly diagnosed with IBD.
We developed and implemented an easy-to-follow algorithm to facilitate screening for and treatment of ID for patients diagnosed with IBD. Through a series of Plan-Do-Study-Act cycles, the approach was modified to increase screening and treatment of ID. Data between January 2019 and July 2021 were assessed using statistical process control.
Among patients newly diagnosed with IBD, 298 patients were included (67% Crohn disease, 29% ulcerative colitis, 4% indeterminate colitis, and 56% males). Rates of ID screening increased significantly from a baseline of 20% to >90%. Of the 232 patients screened for ID during the improvement period, 205 (88%) met criteria for either iron deficiency anemia (IDA) or ID at diagnosis, specifically, 151 (65%) met criteria for IDA and 54 (23%) met criteria for ID.
Use of QI methodology to standardize screening assessments for ID among children newly diagnosed with IBD improved screening rates from a baseline of 20% to >90%, with 88% of patients found to have IDA or ID.
缺铁（ID）无论有无贫血在诊断为炎症性肠病（IBD）的儿童和成人中都很普遍，但往往未被识别。我们推测，质量改进（QI）方法可以提高新诊断为IBD的儿童中ID的筛查和治疗率。
我们制定并实施了一种易于遵循的算法，以促进对诊断为IBD的患者进行ID筛查和治疗。通过一系列计划-执行-研究-行动循环，对该方法进行了改进，以增加ID的筛查和治疗。使用统计过程控制评估2019年1月至2021年7月的数据。
在新诊断为IBD的患者中，纳入了298例患者（67%为克罗恩病，29%为溃疡性结肠炎，4%为不确定性结肠炎，56%为男性）。ID筛查率从基线的20%显著提高到>90%。在改进期间接受ID筛查的232例患者中，205例（88%）在诊断时符合缺铁性贫血（IDA）或ID的标准，具体而言，151例（65%）符合IDA标准，54例（23%）符合ID标准。
使用QI方法对新诊断为IBD的儿童中的ID筛查评估进行标准化，将筛查率从基线的20%提高到>90%，88%的患者被发现患有IDA或ID。
