title: Healthcare Utilisation and Drug Treatment in a Large Cohort of Patients with Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Crohn's disease [CD] and ulcerative colitis [UC] are chronic diseases associated with a substantial utilisation of healthcare resources. We aimed to estimate the prevalence of inflammatory bowel disease [IBD], CD, and UC and to describe and compare healthcare utilisation and drug treatment in CD and UC patients.
  
  
  METHODS
  This was a cross-sectional study of all patients with a recorded IBD diagnosis in Stockholm County, Sweden. Data on outpatient visits, hospitalisations, surgeries, and drug treatment during 2013 were analysed.
  
  
  RESULTS
  A total of 13 916 patients with IBD were identified, corresponding to an overall IBD prevalence of 0.65% [CD 0.27%, UC 0.35%, inflammatory bowel disease unclassified 0.04%]; 49% of all IBD patients were treated with IBD-related drugs. Only 3.6% of the patients received high-dose corticosteroids, whereas 32.4% were treated with aminosalicylates [CD 21.2%, UC 41.0%, p < 0.0001]. More CD patients were treated with biologicals compared with UC patients [CD 9.6%, UC 2.9%, p < 0.0001] and surgery was significantly more common among CD patients [CD 3.0%, UC 0.8%, p < 0.0001].
  
  
  CONCLUSIONS
  This study indicates that patients with CD are the group with the highest medical needs. Patients with CD utilised significantly more healthcare resources [including outpatient visits, hospitalisations, and surgeries] than UC patients. Twice as many CD patients received immunomodulators compared with UC patients and CD patients were treated with biologicals three times more often. These results highlight that CD remains a challenge and further efforts are needed to improve care in these patients.
authors.affiliation: Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden Department of Medical Sciences, Uppsala University, Uppsala, Sweden thomas.cars@sll.se.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cars
authors.affiliation: Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Wettermark
authors.affiliation: Department of Medicine, Karolinska Institutet, Stockholm, Sweden IBD unit at Sophiahemmet, Stockholm, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Löfberg
authors.affiliation: Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Irene
authors.initials: I
authors.lastname: Eriksson
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.affiliation: Department of Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Lördal
mesh_terms: D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology
chemical_list: D005765:Gastrointestinal Agents
keywords: Inflammatory bowel disease; drug treatment; healthcare utilisation