Improving Psychosocial and Lifestyle Factors Reduces Health Care Utilization for IBD

Addressing the psychosocial needs of patients with inflammatory bowel disease (IBD) may improve medical and psychosocial outcomes as well as reduce IBD-related health care utilization costs.

This is a finding of a study presented at Digestive Diseases Week 2016 (May 21-24, 2016; San Diego, CA) that assessed the feasibility and efficacy of a novel pilot program to help patients with IBD improve psychosocial and lifestyle factors and become more involved in their care.

Components of the program, run by a multidisciplinary team, included a social work and psychiatric evaluation, a mind-body stress management program, nutrition counseling, and individualized health education.

The current results were found in 41 patients who had completed the year-long pilot program. All patients had IBD that resulted in 2 or more hospitalizations, 4 or more clinic visits, 3 or more emergency room visits, or were new patients presenting with active disease. The average age was 39 years, with an average disease duration of 12.6 years.

Reporting the results, lead author of the study Joshua Korzenik, MD, Brigham and Women’s Hospital, Boston, MA, highlighted that the main finding was a reduction in the days in the hospital related to IBD for the study group compared with a group of patients who did not participate in the study. Hospital stay for IBD was reduced from 235 days to 127 days for the study group, and the number of imaging studies decreased from 85 to 60.

The study also found a decrease in disease activity scores (a 32% reduction at month 12 compared with baseline) and a reduction in steroid use (with only 8 of 24 patients on steroids at enrollment remaining on the drug at study completion). 

In a subgroup of patients with anxiety at baseline, anxiety scores and depression scores were markedly reduced at the end of the study. 

“For managed care folks, I would suggest that many of the drivers of health care utilization are modifiable factors—such as psychosocial issues, nutrition and lifestyle issues. Programs to address these issues can effectively improve outcomes and reduce costs,” said Dr Korzenik.—Mary Beth Nierengarten