title: Clinical status, psychosocial impairments, medical treatment and health care costs for patients with inflammatory bowel disease (IBD) in Germany: an online IBD registry.
abstract: BACKGROUND
  The aim of this cross-sectional study was to establish an online inflammatory bowel disease (IBD) registry for a first picture of the situation of IBD outpatients' treatment in Germany.
  
  
  METHODS
  Between March 2006 and July 2007 IBD outpatients from 24 gastroenterological specialist practices and two hospitals in Germany were enrolled in an Internet-based registry to evaluate the outpatients' clinical status, psychological impairments, provided health care, as well as medical treatment and medication costs.
  
  
  RESULTS
  1032 IBD patients (ulcerative colitis/UC: 519; Crohn's disease/CD: 511; indeterminate colitis: 2) were enrolled in the study (age: 43 ± 14 years/M ± SD). Disease duration of all patients averaged 10 ± 8.5 years. In 519 UC-patients (49% male; 33% pancolitis), 66% were in remission as were 55% of CD patients (37 % male; 41 % active smokers). Associated with higher rates of disease activity (CDAI ≥ 150; CAI>4) were corticosteroids (CD, UC), topical medication (UC), relevant reported depressive symptoms (15%; 6-31%) and impairments in sexuality (21%; 9-42%). Relevant medication groups prescribed were oral aminosalicylates (UC: 70%; CD: 47%); immunosuppressive therapy - mostly azathioprine/6 MP (CD: 47%; UC: 26%), and Infliximab (CD: 8%; UC: 3%). Strongly associated with their clinical disease activity in UC as well as CD patients, 15% (6-31%) reported relevant depressive symptoms and 21% (9-42%) relevant impairments in sexuality.
  
  
  CONCLUSIONS
  The registry constitutes a large complemental database for the patient population in Germany. About one third of the IBD patients were not in clinical remission (CDAI ≥150/CAI >4) (CD: 45%; UC: 27%), although high rates of immunosuppressive drugs (CD: 47%; UC 26%) were administered. This study shows a large burden of active disease associated with an unexpectedly high (co)morbidity and high psychosocial impairments, indicating a reduced health state in IBD patients.
authors.affiliation: Gastroenterology Practice, Minden, Germany. bernd.bokemeyer@t-online.de
authors.forename: B
authors.initials: B
authors.lastname: Bokemeyer
authors.forename: J
authors.initials: J
authors.lastname: Hardt
authors.forename: D
authors.initials: D
authors.lastname: Hüppe
authors.forename: A
authors.initials: A
authors.lastname: Prenzler
authors.forename: S
authors.initials: S
authors.lastname: Conrad
authors.forename: M
authors.initials: M
authors.lastname: Düffelmeyer
authors.forename: P
authors.initials: P
authors.lastname: Hartmann
authors.forename: M
authors.initials: M
authors.lastname: Hoffstadt
authors.forename: T
authors.initials: T
authors.lastname: Klugmann
authors.forename: C
authors.initials: C
authors.lastname: Schmidt
authors.forename: J
authors.initials: J
authors.lastname: Weismüller
authors.forename: T
authors.initials: T
authors.lastname: Mittendorf
authors.forename: H
authors.initials: H
authors.lastname: Raspe
mesh_terms: D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000191:economics / Q000523:psychology*; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy / Q000191:economics / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D016527:Drug Costs; D005260:Female; D005858:Germany; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D000069285:Infliximab; D020407:Internet; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology; D012907:Smoking; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D002097:C-Reactive Protein; D000069285:Infliximab