An integrated model of care for inflammatory bowel disease sufferers in Australia: development and the effects of its implementation.

Mikocka-Walus, Antonina, Turnbull, Deborah, Holtmann, Gerald and Andrews, Jane M 2012, An integrated model of care for inflammatory bowel disease sufferers in Australia: development and the effects of its implementation., Inflammatory bowel diseases, vol. 18, no. 8, pp. 1573-1581, doi: 10.1002/ibd.22850.

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Title An integrated model of care for inflammatory bowel disease sufferers in Australia: development and the effects of its implementation.
Author(s) Mikocka-Walus, AntoninaORCID iD for Mikocka-Walus, Antonina
Turnbull, Deborah
Holtmann, Gerald
Andrews, Jane M
Journal name Inflammatory bowel diseases
Volume number 18
Issue number 8
Start page 1573
End page 1581
Total pages 9
Publisher Wiley
Place of publication Hoboken, N. J.
Publication date 2012-08
ISSN 1536-4844
Keyword(s) integrated model of care
inflammatory bowel disease
mental health
health systems
Summary BACKGROUND: Psychological comorbidities are associated with poor outcome and increased healthcare utilization in patients with inflammatory bowel disease (IBD). However, a model of care addressing the biopsychosocial dimension of disease is not routinely applied in IBD. This review describes the development of such a model and the effects of its implementation in a hospital-based cohort of patients with IBD. METHODS: Three different approaches were used: 1) collecting baseline epidemiological data on mental health comorbidities; 2) raising awareness of and targeting mental health problems; 3) examining the effects of the model implementation. RESULTS: High rates of anxiety and depressive symptoms (36% and 13%, respectively) that are maintained over time were identified in IBD patients presenting at a metropolitan teaching hospital. Patients with documented psychological comorbidities were more likely to be hospitalized than those without (odds ratio [OR] = 4.13, 95% confidence interval [CI]: 1.25, 13.61). Improvements in disease activity, anxiety, depression, quality of life, and coping have been noted when cognitive-behavioral therapy (CBT) was provided to patients. A drop in the use of opiates (P = 0.037) and hospitalization rates (from 48% to 30%) in IBD patients has been noted as a result of introduction of the changed model of care. In addition, the mean total cost of inpatient care was lower for IBD patients than controls (US$12,857.48 [US$15,236.79] vs. US$ 30,467.78 [US$ 53,760.20], P = 0.005). CONCLUSION: Our data to date suggest that an integrated model of care for patients with IBD may yield superior long-term outcomes in terms of medication use and hospitalization rates and reduce healthcare costs.
Language eng
DOI 10.1002/ibd.22850
Field of Research 110307 Gastroenterology and Hepatology
111708 Health and Community Services
111709 Health Care Administration
110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 920105 Digestive System Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, Crohn’s & Colitis Foundation of America, Inc.
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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