Diagnosis and treatment of IBS within the primary care in Örebro län.
Diagnosis and treatment of IBS within the primary care in Örebro län.
Project number : 252661
Created by: Michiel van Nieuwenhoven, 2018-08-29
Last revised by: Michiel van Nieuwenhoven, 2018-08-29
Project created in: FoU Region Örebro län

Not uppdated, final reminderNot uppdated, final reminder
2019-01-01
Rekrytering/datainsamling pågår

Titel och sammanfattning

Populärvetenskaplig sammanfattning

Irritabel tarmsyndrom (IBS) är en vanlig funktionell gastrointestinal sjukdom. Patienter lider av buksmärta och avföringsrubbningar. Nya uppgifter tyder på att 85 miljoner Europeiska medborgare idag lider av IBS.  Det är en tillstånd som man bruka behandla inom primärvården och det är sällan nödvändig att remittera patienter till sjukhuset. Samhällskostnaderna för IBS är höga.

Man ställer diagnoser med så kallade Rome Kriterier och  begränsade laboratoriumprover. Dock använder man inom primärvården ofta alledeles för mycket onödiga diagnostik, t.ex. röntgen och endoskopiundersökningar, som är meningslösa, belastande för patienten och kostar dessutom mycket pengar. Det finns internationelle riktlinjer avseende diagnostik  och behandling av IBS.

Syftet av denna studie är att kartlägga om läkare inom primärvården använder korrekta diagnostiska verktyg och korrekta behandlingar för IBS. Dessutom vill vi beräkna hur mycket pengar man spenderar i onödan för att ställa IBS diagnosen.

Sammanfattning på engelska

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Patients suffer from abdominal pain and disturbed bowel habits. New data indicate that 85 million European citizens today suffer from IBS. It is a condition that is usually treated within the primary care and it is seldom necessary to refer patients to the hospital. The societal costs for IBS are high.

To diagnose IBS, the so-called Rome Criteria combined with limited laboratory tests should be used. However, within the primary care, too much unnecessary diagnostics, for example radiology and endoscopy, are used. This is meaningless, stressful for the patient and they also cost a lot of money. There are international guidelines for diagnosis and treatment of IBS.

The purpose of this study is to establish whether primary care physicians use correct diagnostic tools and correct treatments for IBS. In addition, we want to calculate how much money is spend unnecessarily to diagnose IBS.

Projektspecifik information

Ämnesord

checked Allmänmedicin
checked Gastroenterologi
checked Hälsoekonomi


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Studietyp

Observationsstudie

Randomiserad studie

Nej

Diagnoskod för huvuddiagnos

K55-K64 Andra sjukdomar i tarmen

Diagnoskod för underdiagnos

K55-K64 Andra sjukdomar i tarmen

Multicenterstudie

Nej

Inklusionsstatus

 Planerat antalAntal tillfrågadeScreen-failureAntal randominserade
n=Det gäller en 5 år retrospektiv registerstudie. Alla nya IBS patienter under denna period kommer att blir inkluderad.   

Vetenskaplig sammanfattning

The defining features of IBS comprise the presence of recurrent abdominal pain in association with altered bowel habits (diarrhea, constipation or both), as stated in the Rome IV criteria. The spectrum, duration and severity of symptoms can range from inconvenient to incapacitating, and can prevent individuals from participating in everyday activities. Despite the prevalence of IBS, its diagnosis and management remain as challenges for global healthcare systems. For this reason, a panel of international experts in the field of FGIDs discussed and agreed on the development of simplified algorithms for the diagnosis and management of IBS. As there is no specific biomarker or test to confirm or rule out a diagnosis of IBS, the Rome IV guidelines outline how the diagnosis of IBS requires a thoughtful approach, limited diagnostic tests, and careful follow-up.

In summary;

Patients have to meet the Rome IV diagnostic criteria.

In general, the risk of organic pathology is very low in young patients with symptoms suggestive of IBS, so invasive investigation is not warranted. This means that limited laboratory tests are sufficient. These tests comprise Hb, CRP, celiac disease serology (anti-TTG), TSH, and fecal calprotectin. If these tests are negative and the patient fulfills the Rome IV criteria, the patient reaches a positive diagnosis of IBS. Endoscopic and radiologic evaluations are seldom useful and may even contribute to an increased patient anxiety.

Treatment of IBS comprises, in summary, information to patients, dietary treatment, pharmacological treatment and psychological treatment.

Since the majority of patients with irritable bowel syndrome (IBS) are diagnosed and treated in primary care, the aim of this project is to investigate the implementation of the Rome criteria in daily primary care clinical practice and adherence of general practitioners (GPs) to recommended diagnostic and therapeutic approaches for IBS.

Another aim is to assess the IBS-related healthcare costs within the primary care, as well as assessment of unnecessary costs associated with diagnosing IBS, such as unnecessary endoscopic evaluation, radiologic evaluation and blood test.

Involverade parter

Arbetsplats

Added workplaces

Regioner - Region Örebro Län - Hälso- och sjukvård - Område medicin och rehabilitering - Medicinska kliniken workplace verified by Region Örebro län on 2018-06-14

Projektägare är huvudprövare eller ansvarig forskare

checked Ja


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Medarbetare i projektet

Roll i projektet

checked Medarbetare

Diagnosis and treatment of IBS within the primary care in Örebro län., from FoU Region Örebro län
http://www.researchweb.org/is/en/fourol/project/252661