Limsrivilai Julajak, Lai Allen Yu-Hung, Li Silvia T H, Abdullah Murdani, Ali Raja Affendi Raja, Aniwan Satimai, Bui Hoang Huu, Chou Jen-Wei, Hilmi Ida Normiha, Lim Wee Chian, Sollano Jose, Teo Michelle Mui Hian, Wei Shu-Chen, Leung Wai Keung
Division of Gastroenterology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
Intest Res. 2025 Apr;23(2):117-128. doi: 10.5217/ir.2024.00085. Epub 2025 Jan 6.
Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.
临床指南通常认可传统疗法,如5-氨基水杨酸(5-ASA)作为溃疡性结肠炎治疗的主要手段。然而,亚洲医生对指南建议的采纳和应用程度仍不明确。本研究旨在了解5-ASA的处方模式以及当前指南建议在亚洲临床实践中的实施情况。对8个亚洲地区的炎症性肠病专家进行了一项医生调查,以了解溃疡性结肠炎治疗的实践和偏好,重点关注5-ASA的使用以及与指南建议的一致性。调查结果由不同医疗环境下的国家专家进行了验证。亚组分析按收入水平和治疗报销状况对数据进行了分层。从8个经济体的炎症性肠病专家或胃肠病学家那里收到了98份有效回复。在不同收入水平和政府补贴组之间,溃疡性结肠炎治疗的临床实践和治疗偏好存在显著差异。调查结果总结为8项发现,阐明了亚洲各地区5-ASA使用和指南实施的趋势。本研究强调了影响现实世界实践中指南建议采纳的社会经济因素。我们的研究结果表明,基于资源可用性和治疗目标的可行性,亚洲在指南实施方面采取了折衷的方法。