P568. Adherence to quality measures for inflammatory bowel disease in Korea: Questionnaire study based on American Gastroenterological Association Adult Inflammatory Bowel Disease Physician Performance Measures Set
H.K. Song1, S.-A. Jung1, J.M. Cha2, S.N. Hong3, G.S. Seo4, K.-M. Lee5, Y.-H. Kim3, D.S. Han6, S.-K. Yang7, 1Ewha Womans University School of Medicine, Internal Medicine, Seoul, Korea, Republic of, 2Kyung Hee University College of Medicine, Internal Medicine, Seoul, Korea, Republic of, 3Sungkyunkwan University School of Medicine, Internal Medicine, Seoul, Korea, Republic of, 4Wonkwang University College of Medicine, Internal Medicine, Iksan, Korea, Republic of, 5College of Medicine, The Catholic University of Korea, Internal Medicine, Seoul, Korea, Republic of, 6Hanyang University College of Medicine, Internal Medicine, Guri, Korea, Republic of, 7Ulsan University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
Adherence to quality measures is crucial for quality improvement in care of patients with Inflammatory Bowel Disease (IBD). The aim of this study was to evaluate adherence to quality measures for IBD in current practice in Korea.
Self-administered questionnaires based on adult inflammatory bowel disease physician performance measures set from American Gastroenterological Association (AGA) were distributed to physicians of Korean Association for the Study of Intestinal Disease (KASID) members who treat IBD in Korea. E-mail survey was conducted. Physicians were classified according to years of IBD practice experience; less than 5-year group, more than 5-year and less than 10-year group and more than 10-year group. We compared adherence to quality measures between the three groups.
Surveys were completed by fifty-two physicians (response rate 72.2%). More than 10-year group had significantly more new patients per year and cumulative patients. Most physicians performed documents of IBD type, anatomic location and activity (95.3%), recommending corticosteroid sparing therapy (90.6%), testing for latent TB before initiating anti-TNF therapy (86.0%), testing for Clostridium difficile to inpatients with diarrhea (90.7%) and screening for tobacco use (81.4%) to all IBD patients. Hepatitis B virus status was assessed before initiating anti-TNF therapy to all IBD patients by 61.5% of physicians. Less than 40% of physicians performed bone loss assessment for corticosteroid-related iatrogenic injury (11.6%), influenza immunization (39.5%), pneumococcal immunization (16.3%), prophylaxis for venous thrombosis to IBD inpatient (0%) and tobacco cessation counseling intervention for tobacco users (34.9%). More than 10-year group showed lower adherence to bone loss assessment and tobacco cessation counseling intervention than other groups.
Korean physicians who treat IBD showed high adherence to many of quality measures. However, there were still performance gaps in IBD care, such as bone loss assessment, influenza and pneumococcal immunization, prophylaxis for venous thrombosis and tobacco cessation intervention, which were similar with Western reports. For quality improvement, it is needed to educate quality measures and to continue to discuss about evidence-based clinical practice guidelines for IBD in Korea.