P1595 - Utility of Establishing an IBD Unit in a Veteran Affairs Gastroenterology Department

Yinglin Gao, DO, Anish Patel, MD, Muhammad B. Hammami, MD
Loma Linda University Medical Center, Loma Linda, CA

Introduction: The optimal management of patients with inflammatory bowel disease (IBD) is rapidly evolving and becoming increasingly complicated. Several studies have demonstrated the utility of establishing specialized units in the management of various diseases. We examined the advantage of establishing a specialized IBD unit at the Loma Linda Veteran Affairs Hospital (LLVAH).

Methods: We reviewed the medical records of all IBD patients who had ≥1 clinical encounter over a 12-month period in a newly established IBD unit and ≥1 clinical encounter over the prior 12-months in the general GI clinic at the LLVAH. We compared the number of encounters (GI/IBD and primary care, PCP), hospitalizations (number and duration), glucocorticoid prescriptions (number and cumulative dose), and compliance with guideline-recommended vaccination and health care maintenance.

Results: One hundred thirty-two patients fulfilled the inclusion criteria. Their median age was 66 (range 23-98) years; 120 (90.9%) were male; 95 (72%) Caucasian, 15 (11.4%) African American, and 22 (16.7%) of other ethnicities; 66 (50%) had ulcerative colitis, 60 (45.5%) Crohn’s disease, and 6 (4.5%) indeterminate colitis. GI/IBD and PCP encounters were reduced by 16.5% and 13%, respectively (from 526 to 439 and 193 to 168). Hospitalized patients’ number was reduced by 37.5% (16 to 10), total hospitalizations number by 43.5% (23 to 13), IBD flare hospitalizations number by 61.5% (13 to 5), and total hospitalization days by 58.6% (140 to 58). Prednisone and budesonide prescriptions were reduced by 44.5% and 38.3%, respectively (117 to 65 and 47 to 29). Cumulative prednisone and budesonide doses (mg) were reduced by 39.8% and 7.4%, respectively (63510 to 38264 and 7806 to 7248). The number of recommended vaccinations (HAV, HBV, PNA, TDAP, and shingles), skin cancer screening, eye examination, and depression/anxiety screening provided increased by 69.2% (40 to 130), 24.3% (28 to 37), 34.9% (28 to 43), and 26.1% (34 to 46), respectively.

Discussion: The study demonstrates an association between establishing a specialized IBD unit and reducing hospitalizations, outpatient encounters, and glucocorticoid use, and improved adherence to guideline-recommended vaccination and health care maintenance. Although limited by a relatively small sample size, retrospective nature, and pre-post design, the study highlights the importance of establishing specialized IBD units to deliver optimal patient care.


Disclosures:


Yinglin Gao, DO, Anish Patel, MD, Muhammad B. Hammami, MD. P1595 - Utility of Establishing an IBD Unit in a Veteran Affairs Gastroenterology Department, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.