Posted by Jonathan Moses on April 14, 2021
Study Authors
Jonathan Moses, Kelly Sandberg, Gabriel Winberry, Diana Riera, Sarah DeLozier, Sandeep K Gupta, Norelle Reilly, K T Park, Joseph Picoraro
Study Background
As a community of physicians, our practice has shifted towards following not just symptoms, but assessing the lining of the gut to see if there is healing when judging medication effectiveness, so called “mucosal healing” or endoscopic remission. There are data suggesting patients with IBD who achieve endoscopic remission have better long-term outcomes, such as longer time spent in remission and less hospitalizations/surgeries. Although this practice has become commonplace in the care of adults with IBD, it is unclear how often this practice of repeat endoscopy after starting a new medication is being used in pediatric IBD. Given this is a clinical practice survey, having access to the providers directly to participate was a key to our success. Using the ICN Listserv to contact providers directly allowed us to collect data on practice patterns for this study. In addition, the ICN Research Committee provided invaluable scientific oversight of our study design.
Study Overview
The aim of our study was to assess the use of repeat endoscopy after the start of a new medication using a clinical practice survey targeted to practicing pediatric gastroenterologists. We also aimed to examine any factors related to the providers that may affect whether or not they repeat endoscopy routinely. Primarily pediatric gastroenterologists who would be making the decision on the need for repeat endoscopy completed the survey. The results of this study helped us better understand how often pediatric gastroenterologists repeat endoscopy, which was previously unknown. One of the limitations of the study was the low response rate, which may limit how generalizable the data is across the ICN community. We also did not include patient and parental views on repeat endoscopy.
Study Results - What does it all mean?
Prior to completing this study, we did not have a good understanding of how often pediatric gastroenterologist utilized repeat endoscopy in their clinical practice. Looking at the results of the clinical practice survey, we found a high rate of respondents (68% of them) do use repeat endoscopy, and they tended to be in practice for fewer years (1-10 years) than those who did not repeat endoscopy (greater than 15 years). We hope this data is able to support future efforts to examine the long-term outcomes of children and adolescents with IBD who achieve endoscopic remission. We would also hope future studies include patients and parents in the study design and results to better understand their thoughts on the need for repeat endoscopy in routine clinical care.
Study status
As of February 24, 2021, this study has been published online ahead of print in the Journal of Pediatric Gastroenterology and Nutrition. It has been added to our list of published research studies. You can view our community's published research by visiting our Publications page >>