Hussain Fatima S, Setya Aniruddh, Molina Isaac, Chaudhry Naueen A, Chi Xiaofei, Gurka Matthew J, Filipp Stephanie L, Pham Angela, Kerman David, Abreu Maria T, Zimmermann Ellen M
Department of Pediatrics, University of Florida, Gainesville, Florida.
Department of Medicine, University of Florida, Gainesville, Florida.
Gastro Hep Adv. 2023 Jun 30;2(7):928-934. doi: 10.1016/j.gastha.2023.06.009. eCollection 2023.
Late adolescents and young adults (AYA) with inflammatory bowel disease (IBD) are a vulnerable population as they transition to adult healthcare. We aim to provide a real-world data on their healthcare utilization patterns and medication use through a large database.
We performed a retrospective cohort study from January 1, 2012, to June 30, 2020, using OneFlorida Data-Trust, an electronic health record-based data repository representing over half of the Florida population. Outcomes of interest included demographics, healthcare utilization, medications, and disease severity. Chi-square tests and logistic regression were used to compare the rates of medication use, healthcare utilization, and disease severity by age groups.
The number of patients who met our inclusion criteria was 10,578 with 2731 (25.8%) in the 17-25-year-old group. AYA patients had fewer ambulatory visits vs children (90% vs 95%; value <.05). AYA patients were admitted more frequently from emergency facilities vs children (22.3% vs 10.9%; value <.05). AYA patients received steroids more often than adults and younger patients (48.9% vs 45.3 vs 44.3% value <.05, respectively). AYA patients received more narcotic (41.1% vs 22.3 % value <.05) and antidepressant prescriptions (15.9% vs 9.5%; value <.05) compared with children. With advancing age, a decrease in biologic use was noted (51% vs 40% vs 25.4% value <.05, respectively).
AYA patients with IBD have higher rates of hospital admissions from emergency department, fewer ambulatory health visits and they receive more steroids compared to children. Our study demonstrates the need for age-specific IBD programs for AYA patients.
患有炎症性肠病（IBD）的青少年晚期及青年（AYA）在向成人医疗保健过渡时是弱势群体。我们旨在通过一个大型数据库提供关于他们医疗保健利用模式和药物使用的真实世界数据。
我们使用OneFlorida数据信托进行了一项回顾性队列研究，该数据信托是一个基于电子健康记录的数据存储库，代表了超过一半的佛罗里达人口，时间跨度为2012年1月1日至2020年6月30日。感兴趣的结果包括人口统计学、医疗保健利用、药物和疾病严重程度。使用卡方检验和逻辑回归按年龄组比较药物使用、医疗保健利用和疾病严重程度的比率。
符合我们纳入标准的患者有10578人，其中17至25岁年龄组有2731人（25.8%）。与儿童相比，AYA患者的门诊就诊次数较少（90%对95%；P值<.05）。与儿童相比，AYA患者从急诊设施入院的频率更高（22.3%对10.9%；P值<.05）。AYA患者比成人和更年轻的患者更常接受类固醇治疗（分别为48.9%对45.3%对44.3%，P值<.05）。与儿童相比，AYA患者接受更多的麻醉剂（41.1%对22.3%，P值<.05）和抗抑郁药处方（15.9%对9.5%；P值<.05）。随着年龄的增长，生物制剂的使用有所减少（分别为51%对40%对25.4%，P值<.05）。
与儿童相比，患有IBD的AYA患者从急诊科入院的比率更高，门诊健康就诊次数更少，且接受更多的类固醇治疗。我们的研究表明需要针对AYA患者制定特定年龄的IBD项目。
