Loss to follow-up common with IBD, but many have flare-ups

(HealthDay)—Loss to follow-up is common with inflammatory bowel disease (IBD), and both low C-reactive protein levels and long travel time to the hospital are predictors of follow-up loss, according to a study published in the Journal of Gastroenterology and Hepatology.

Dae Hyung Woo, from the Yeungnam University College of Medicine in South Korea, and colleagues analyzed the frequency, predictors, and clinical outcomes of patients with IBD who are lost to follow-up in outpatient clinics. Analysis included 285 newly diagnosed IBD patients (161 with ulcerative colitis and 124 with Crohn's disease) who were followed for at least 12 months.

The researchers found that 14.7 percent of the patients were lost to follow-up. Travel time to the clinic (odds ratio [OR], 2.37) and C-reactive protein levels at diagnosis (OR, 0.63) were significantly associated with follow-up loss. The vast majority (85.7 percent) of the 42 patients lost to follow-up revisited the clinic. Disease flare-up was the cause of revisit for 61.1 percent of patients. In 41.7 percent of patients, step-up treatment was needed. Steroids were introduced for 38.9 percent, while azathioprine and an antitumor necrosis factor agent were newly prescribed for 8.3 and 2.8 percent, respectively.

"Because most of follow-up loss patients experienced flare-up, clinicians need to try to encourage patients to keep their adherence," conclude the authors.

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