title: [Significant changes of pharmacotherapy in gastroenterological rehabilitation of Crohn's disease].
abstract: OBJECTIVE
  The pivotal role of optimizing pharmacotherapy is generally accepted in somatic rehabilitation of various specialities like cardiopulmonary rehabilitation. No data exist as to whether significant modifications of pharmacotherapy occur during gastroenterological rehabilitation of Crohn's Disease (CD) patients.
  
  
  METHODS
  A single centre chart review was performed including patients with International Classification of Disease Codes for CD (ICD K50). The Harvey-Bradshaw activity index (HBI) and CD medications were protocolled at the beginning and end of in-patient rehabilitation.
  
  
  RESULTS
  337 of 355 patients with ICD K50 fulfilled the predefined diagnostic criteria of mild to moderate CD (250 female, 87 male, average age of 40 (95% confidenceinterval, 29-51)). Disease activity decreased from 4.9 to 3.7 by 1.2 (0.75-1.37) Units during 23 (20-35) days. On admission, 120 (36%) patients received one and 158 (47%) received two to five CD drugs. CD drug prescriptions changed in 162 (48%) patients. Overall, 116 (34%) patients received systemic steroids which were stopped in 14 patients (p<0.05). In the remaining 102 patients the cortisol equivalence doses decreased from 77 to 56 mg by 21 (14-28) mg. The number of patients on azathioprine (AZT) increased from 98 to 108 (p<0.05). The average AZT dose increased from 1.81 to 1.99 mg/kg in 97 rehabilitants continuously treated.
  
  
  CONCLUSIONS
  Our results describe an association between rehabilitation and significant changes of CD-specific pharmacotherapy in line with current treatment guidelines. This supports the concept that future studies on effects of gastroenterological rehabilitation should control for changes in pharmacotherapy.
authors.affiliation: Reha-Zentrum Bad Brückenau, Klinik Hartwald, Deutsche Rentenversicherung Bund, Bad Brückenau. christoph.reichel@web.de
authors.forename: C
authors.initials: C
authors.lastname: Reichel
authors.forename: J
authors.initials: J
authors.lastname: Streit
authors.forename: S
authors.initials: S
authors.lastname: Wunsch
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001379:Azathioprine / Q000008:administration & dosage; D001688:Biological Products / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000175:diagnosis / Q000534:rehabilitation*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001688:Biological Products; D007166:Immunosuppressive Agents; D015122:Mercaptopurine; D001379:Azathioprine; D008727:Methotrexate