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首页> 美国卫生研究院文献>The Ochsner Journal >Health Maintenance and Vaccination of Patients With Inflammatory Bowel Disease: Practice and Perception of Responsibility of Gastroenterologists vs Primary Care Providers
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Health Maintenance and Vaccination of Patients With Inflammatory Bowel Disease: Practice and Perception of Responsibility of Gastroenterologists vs Primary Care Providers

机译：炎症性肠病患者的健康维护和疫苗接种：胃肠病医生与基层医疗服务提供者的责任感的实践和认识

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>Background: Although it is well established that patients with inflammatory bowel disease (IBD) are at increased risk of complicating diseases and vaccination-preventable infections, whether gastroenterologists (GIs) or primary care providers (PCPs) assume responsibility for these patients’ health maintenance is not clear.>Methods: We anonymously surveyed a convenience sample of 94 PCPs and 61 GIs at Saint Louis University School of Medicine in St. Louis, MO, about their practice and perception of the health maintenance and vaccination of patients with IBD.>Results: Response rates were 82% and 93% for GIs and PCPs, respectively. GIs were as likely as PCPs to screen for smoking (88% vs 89%) and were significantly less likely to screen for depression/anxiety (24% vs 54%) or to provide pertussis (14% vs 44%) or diphtheria (20% vs 48%) vaccines. GIs were significantly more likely than PCPs to assess for colonoscopy need (94% vs 80%); to screen for nonmelanoma skin cancer (62% vs 14%), melanoma (56% vs 7%), osteoporosis (72% vs 51%), or tuberculosis (94% vs 44%); to prescribe calcium/vitamin D (74% vs 53%); to perform nutritional assessment (78% vs 33%); or to provide hepatitis A (60% vs 39%) or hepatitis B (86% vs 56%) vaccines. GIs were as likely as PCPs (64% vs 75%) to perceive that PCPs should order vaccinations and significantly more likely to perceive that GIs should track vaccinations (58% vs 16%) and other health maintenance issues (90% vs 49%). We found positive associations between performing the various health maintenance and vaccination tasks and the perception of responsibility.>Conclusion: Several health maintenance aspects are inadequately addressed by GIs and PCPs, in part because of conflicting perceptions of responsibility. Clear guidelines and better GI/PCP communication are required to ensure effective health maintenance for patients with IBD.
机译：>背景：尽管公认的炎症性肠病（IBD）患者更容易罹患疾病和可预防接种的感染，但胃肠病医生（GIs）或初级保健提供者（PCP）承担责任这些患者的健康维护尚不清楚。>方法：我们在密苏里州圣路易斯大学圣路易斯大学医学院匿名调查了94名PCP和61名GI的便利样本。 >结果：胃肠道和PCP的缓解率分别为82％和93％。胃肠道筛查的可能性与PCP筛查的可能性一样（88％对89％），而筛查抑郁/焦虑的可能性（24％对54％）或提供百日咳（14％对44％）或白喉的可能性要低得多（20 ％vs 48％）疫苗。胃肠道评估结肠镜的必要性明显高于五氯苯酚（94％vs 80％）；筛查非黑色素瘤皮肤癌（62％vs 14％），黑色素瘤（56％vs 7％），骨质疏松症（72％vs 51％）或结核病（94％vs 44％）；开钙/维生素D（74％比53％）；进行营养评估（78％比33％）；或提供甲型肝炎（60％比39％）或乙型肝炎（86％比56％）疫苗。胃肠道感染的可能性与PCP者（64％vs 75％）一样，认为PCPs应该订购疫苗，并且更有可能认为GIs应该跟踪疫苗接种（58％vs 16％）和其他健康维护问题（90％vs 49％） 。我们发现执行各种健康维护和疫苗接种任务与责任感之间存在正相关关系。>结论：地理标志和个人护理医师未充分解决几个健康维护方面的问题，部分原因是责任感不同。需要明确的指导方针和更好的GI / PCP沟通，以确保IBD患者的有效健康维护。

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