Anemia is a common complication among patients with inflammatory bowel diseases (IBD) and is associated with high rates of IBD-related complications, resource utilization, and impaired quality of life.
Despite practice guidelines for anemia in patients with IBD, gaps remain in the perceptions of anemia among health care providers.
Dr Jason Hou and colleagues identified gaps in care, and developed a care pathway for anemia in patients with IBD.
|Variations in how providers define iron deficiency, thresholds for treatment of anemia|
|Inflammatory Bowel Diseases|
The Crohn's & Colitis Foundation of America anemia care pathway was developed by a committee using principles of cognitive task analysis.
Focus groups of providers of patients with IBD were performed to identify domains of perceptions, and management decisions for anemia and IBD.
Knowledge elicitation from subject experts in anemia was conducted using case-based scenarios of patients with IBD, and anemia to determine decision-making branch points.
The researchers modified the care pathway in an iterative fashion to encompass clinical presentations of anemia in IBD and potential barriers to the recognition, management, and follow-up of anemia.
The team observed variations in how providers define iron deficiency, thresholds for treatment of anemia, and route of iron therapy.
The team developed a care pathway for anemia incorporating the World Health Organization definition of anemia, universal hemoglobin and ferritin screening, evaluation of iron stores using ferritin and transferrin saturation, management of anemia based on adequacy of iron stores, and follow-up.
Dr Hou's team comments, "The authors identified domains of how providers perceive and manage patients with IBD and anemia, and developed a care pathway to align clinical practices with guideline recommendations."