title: Interventions and targets aimed at improving quality in inflammatory bowel disease ambulatory care.
abstract: Over the past decade, there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases, including inflammatory bowel disease. Inflammatory bowel disease is a complex, chronic condition with associated morbidity, health care costs, and reductions in quality of life. The condition is managed primarily in the outpatient setting. The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity, the use of steroid-sparing agents, screening prior to anti-tumor necrosis factor therapy, and monitoring thiopurine therapy. This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs, quality improvement frameworks, collaborative efforts in quality improvement, and the use of healthcare information technology.
authors.affiliation: Adam V Weizman, Division of Gastroenterology, Women's College Hospital, University of Toronto, Toronto, ON M5S 1B2, Canada.
authors.forename: Adam V
authors.initials: AV
authors.lastname: Weizman
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nguyen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000553:Ambulatory Care / Q000592:standards*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000592:standards*; D016903:Drug Monitoring / Q000592:standards; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents
keywords: Ambulatory care; Crohn’s disease; Inflammatory bowel disease; Quality improvement; Ulcerative colitis