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Documentation of IBD quality measures remains poor
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Academic, clinical and private gastroenterology practices have demonstrated poor documentation of quality measures established by the AGA in 2011 for patients with inflammatory bowel disease.
“Current documented compliance with the AGA quality measures is inadequate across all practice types — academic, community hospital, and private practice. Further studies are necessary to improve the reporting of these measures,” Joseph D. Feuerstein, MD, from Beth Israel Deaconess Medical Center, Harvard Medical School in Boston, and colleagues wrote.
Joseph D. Feuerstein
Feuerstein, along with Daniel A. Leffler, MD, and Adam S. Cheifetz, MD, also from Beth Israel Deaconess, and colleagues conducted a multicenter study to examine documented academic, clinical and private gastroenterology practice compliance with IBD core quality measures. Charts of consecutive patients seen at an academic practice (367 patients), a community practice (217 patients) and a private practice (199 patients) were reviewed for compliance with eight outpatient measures. Of the total cohort, 58% were women, the mean age was 44 years, 340 patients had ulcerative colitis, 432 had Crohn’s disease and 11 had indeterminate colitis.
In all three centers combined, researchers found that only 46 patients (5.8%) had appropriate documentation of all eight core measures (24 patients in the academic practice, none in the clinical practice and 22 in the private practice).
The core measure most often recorded was screening for tobacco abuse (89.6% of all patients). The location of IBD was the second most assessed and documented core measure (80.3%) and the third was assessment for corticosteroid-sparing therapy (70.8% of all patients).
The following measures were least likely to be evaluated: pneumococcal immunization (16.7%), bone loss (25%) and influenza immunization (28.7%).
Daniel A. Leffler
Adam S. Cheifetz
Researchers found the year of graduation from fellowship (OR = 2.184; 95% CI, 1.522-3.134), the year of graduation from medical school (OR = 0.5; 95% CI, 0.352-0.709) and the total number of comorbidities (OR = 1.089; 95% CI, 1.016-1.168) were associated with compliance in reporting all core measures.
“The only increased awareness would relate to the AGA publicizing the measures. This may have resulted in some improved compliance at the [community practice] and [private practice], but our results indicated that the compliance still was inadequate overall,” the researchers wrote.
Disclosures: Cheifetz reports consulting or receiving grants from AbbVie, Janssen, Pfizer, Takeda and Prometheus. Leffler reports consulting or receiving grants from Prometheus Diagnostics, Alba Pharmaceuticals, Alvine Therapeutics and Shire Therapeutics.
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