Solitano Virginia, Bernstein Charles N, Dotan Iris, Dignass Axel, Domilici Rhondell, Dubinsky Marla C, Gearry Richard B, Hart Ailsa, Kaplan Gilaad G, Ma Christopher, Magro Fernando, Mak Joyce Wing Yan, Ng Siew C, Panaccione Remo, Raja Sreecanth, Rubin David T, Siegel Corey A, Jairath Vipul, Peyrin-Biroulet Laurent, Danese Silvio
Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Nat Rev Gastroenterol Hepatol. 2025 Apr 22. doi: 10.1038/s41575-025-01063-x.
Inflammatory bowel disease (IBD) is a growing global health challenge affecting more than 7 million people worldwide. With increasing prevalence across all age groups, including children and adolescents, IBD places substantial strain on health-care systems and society, resulting in high direct medical costs, lost productivity and reduced quality of life. Despite therapeutic advances, suboptimal disease control and delays in timely diagnosis and adequate treatment persist. Regional disparities in health-care access contribute to these challenges, especially in low-income countries. Addressing these inequities is crucial for improving global IBD outcomes. Using a Delphi methodology, experts from clinical care, research, public health and advocacy (including patient representation) identified priorities across six domains (37 statements in total): epidemiology, care models, treatment strategies, education and awareness, patient and community engagement, and leadership to promote health equity. These priorities emphasize quantifying the burden of IBD, addressing health-care disparities, validating care models, exploring novel treatments, advancing education, engaging patients and advocating for health equity policies. The comprehensive approach seeks to optimize care models, promote patient engagement and ensure equitable access to health care. The identified priorities serve as a guide for both clinical and non-clinical researchers, and funders dedicated to IBD-related initiatives, fostering international collaboration to improve IBD management and reduce its impact globally.
炎症性肠病(IBD)是一项日益严峻的全球性健康挑战,全球有超过700万人受其影响。随着包括儿童和青少年在内的所有年龄组患病率不断上升,IBD给医疗保健系统和社会带来了巨大压力,导致高昂的直接医疗费用、生产力损失和生活质量下降。尽管治疗取得了进展,但疾病控制仍不理想,及时诊断和充分治疗也存在延误。医疗保健可及性方面的地区差异加剧了这些挑战,在低收入国家尤为如此。解决这些不平等问题对于改善全球IBD治疗效果至关重要。通过德尔菲法,来自临床护理、研究、公共卫生和宣传(包括患者代表)领域的专家确定了六个领域的优先事项(共37条陈述):流行病学、护理模式、治疗策略、教育与认知、患者及社区参与以及促进健康公平的领导力。这些优先事项强调量化IBD负担、解决医疗保健差异、验证护理模式、探索新疗法、推进教育、让患者参与以及倡导健康公平政策。这种综合方法旨在优化护理模式、促进患者参与并确保公平获得医疗保健。确定的优先事项为临床和非临床研究人员以及致力于IBD相关倡议的资助者提供了指导,促进国际合作以改善IBD管理并减少其在全球的影响。