A real world investigation on prevalence, clinical features, and therapy of inflammatory bowel disease in the city of Messina, Italy. Epidemiology and clinical features of IBD in Messina

Main Article Content

Alessandra Belvedere
Riccardo Scoglio
Anna Viola
Giuseppe Costantino
Aldo Sitibondo
Marco Muscianisi
Santi Inferrera
Angela Alibrandi
Walter Fries

Keywords

General Practitioner, epidemiology, mesalazine, extraintestinal manifestations

Abstract

Background: The absence of a national register of inflammatory bowel diseases (IBD) hinders effective health care planning in Italy.


Aims: to investigate prevalence of IBD in the city of Messina, Italy, based on General Practitioner (GP) records, and to establish current treatments prescribed by different health care providers.


Methods: data were extracted from GP databases with the help of disease-specific healthcare cost exemption codes combined with ICD9 codes for ulcerative colitis (UC) and Crohn’s disease (CD), and prescription for mesalazine. Disease and treatment-related data were collected together with information on employment status and the current healthcare provider.


Results: Eighty-six GPs participated covering a population of 100,834 people. IBD prevalence (419/105) was 80% higher than estimates of the Regional Health Authorities. Incidence showed a seven-fold increase over the past 30 years. Only 51% of CD and 26% of UC patients were followed by a dedicated IBD centre with more frequent prescriptions of immunomodulators and biologics (p<0.001) compared to GPs.


Conclusions: Real world data show much higher figures on IBD prevalence than administrative estimates. Differences in therapeutic approaches between IBD-specialists and non-specialists may reflect poor confidence in managing immunosuppressive therapies by the latter, but may lead to inadequate therapy and cancer surveillance.


 

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