Barbina Sarah, Romano John, Forster Erin
Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
Crohns Colitis 360. 2023 Feb 2;5(2):otad002. doi: 10.1093/crocol/otad002. eCollection 2023 Apr.
Therapy and management of inflammatory bowel disease (IBD) require commitment from both the provider and patient to ensure optimal disease management. Prior studies show vulnerable patient populations with chronic medical conditions and compromised access to health care, such as incarcerated patients, suffer as a result. After an extensive literature review, there are no studies outlining the unique challenges associated with managing prisoners with IBD.
A detailed retrospective chart review of 3 incarcerated patients cared for at a tertiary referral center with an integrated patient-centered IBD medical home (PCMH) and a review of literature was performed.
All 3 patients were African American males in their 30s with severe disease phenotypes requiring biologic therapy. All patients had challenges with medication adherence and missed appointments related to inconsistent access to clinic. Two of the 3 cases depicted better patient-reported outcomes through frequent engagement with the PCMH.
It is evident there are care gaps and opportunities to optimize care delivery for this vulnerable population. It is important to further study optimal care delivery techniques such as medication selection, though interstate variation in correctional services poses challenges. Efforts can be made to focus on regular and reliable access to medical care, especially for those who are chronically ill.
炎症性肠病（IBD）的治疗和管理需要医疗服务提供者和患者共同努力，以确保实现最佳的疾病管理。先前的研究表明，患有慢性疾病且获得医疗保健机会有限的弱势群体，如被监禁的患者，会因此受到影响。在广泛查阅文献后，尚无研究概述管理IBD囚犯所面临的独特挑战。
对在一家拥有以患者为中心的综合IBD医疗之家（PCMH）的三级转诊中心接受治疗的3名被监禁患者进行了详细的回顾性病历审查，并对文献进行了综述。
所有3名患者均为30多岁的非裔美国男性，患有严重的疾病表型，需要生物治疗。所有患者在药物依从性方面都存在困难，并且由于无法按时就诊而错过预约。3例中有2例通过与PCMH的频繁接触，患者报告的结果有所改善。
显然，对于这一弱势群体，存在护理差距和优化护理服务的机会。进一步研究最佳护理服务技术（如药物选择）很重要，尽管惩教服务的州际差异带来了挑战。可以努力专注于定期且可靠地获得医疗护理，尤其是对于那些患有慢性病的人。
