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The ACG recently published clinical guidelines addressing preventive care in patients with IBD. Several of the issues they highlight are linked to the use of biologics and other long-term immune-suppressive therapies.
Recent data suggest that inflammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identification, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identification of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary.
Farraye FA, Melmed GY, Lichtenstein GR, Kane SV. ACG Clinical Guideline:
Preventive Care in Inflammatory Bowel Disease. Am J Gastroenterol. 2017
Feb;112(2):241-258. doi: 10.1038/ajg.2016.537. Epub 2017 Jan 10. Review. PubMed
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