P-172 African American Patients with IBD Are More Frequently Screened for TB Prior to Initiating Biologic Therapy. (February 2017)

• Record Type: Journal Article
• Authors: Farhat, Freba; Chandler, Matthew; Borum, Marie
• Is Part Of: Inflammatory bowel diseases. Volume 23(2017)Supplement 1
• Publication Date: 2017-02
• Subjects: Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1097/01.MIB.0000512688.46504.c7
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract : Background: The needs of individuals diagnosed with Inflammatory Bowel Disease (IBD) increase substantially given the robust screening measures and follow-up required to ensure patient safety. Part of this screening measure includes tuberculosis screening prior to the initiation of treatment with immune modulating therapies. While the advancement of medicine has decreased disease burden and more importantly allowed patients to lead extremely active lives. With the advancement of complex medical regimens physicians must contend and recognize the nuanced parameters for monitoring safety profiles, adverse effects and overall adherence to medical therapy. Methods: The study focused on monitoring a patient panel with a diagnosis of IBD at an urban academic medical center. The analysis focused on the panel's follow up during a 6-month period between December 2015 and May 2016. The study analyzed the rate of screening of TB screening among African American and non African American patients. We utilized the Fisher's exact test one-tailed analysis with a set P -value of 0.05. Results: Analysis of the study highlighted a significant difference in the rate of screening for TB between these 2 groups. Among the African American patient panel 41 out of a total of 82 patients received appropriate TB screening (50%). However, the non African American group only 62 of the total 163 patients received such monitoring (38%). With the P -value calculated at 0.05 the above study highlights statistically significant data when comparing the difference in screening among different racial groups. Conclusions: Based on the results of our study, African Americans receive greater screening of TB prior to the initiation of immune suppressive therapy when compared to other races. The significance of this data highlights a key difference in the rate of screening of TB prior to the initiation of immune suppressive therapies such as immune modulators and/or cytotoxic agents. While the study did not focus on the reasons contributing to this statistical difference between the 2 groups the risk of not screening for TB is still present and a great concern. One can postulate that it may be the challenges of recollecting the guidelines for every patient during the finite time spent with the patient in the clinic setting. The lack of an integrated EMR system that is not able to monitor for such lapses in care and monitoring also hinder clinicians' ability to ensure the safety profile for each and every patient. This study hopes to shed light on the limitations of our clinical practice so that we can begin a much longer discussion on ways to ensure the safety and accessibility of all services to every patient.