Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION studyPhysician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
- Authors
- Park, Yehyun; Choi, Chang Hwan; Kim, Hyun Soo; Moon, Hee Seok; Kim, Do Hyun; Kim, Jin Ju; Teng, Dennis; Park, Dong Il
- Issue Date
- Oct-2022
- Publisher
- KOREAN ASSOC STUDY INTESTINAL DISEASES
- Keywords
- Crohn disease; Inflammatory bowel disease; Steroids; Colitis; ulcerative
- Citation
- INTESTINAL RESEARCH, v.20, no.4, pp 452 - 463
- Pages
- 12
- Journal Title
- INTESTINAL RESEARCH
- Volume
- 20
- Number
- 4
- Start Page
- 452
- End Page
- 463
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/56851
- DOI
- 10.5217/ir.2021.00125
- ISSN
- 1598-9100
2288-1956
- Abstract
- Background/Aims: Epidemiological data on steroid use in South Korean patients with inflammatory bowel disease (IBD) are limited. We documented the steroid use patterns in these patients, and whether physician education on appropriate steroid use affected these patterns. Methods: ACTION was an observational cohort study conducted in adults (>= 19 years) with IBD. A ret-rospective chart review was performed at baseline (cohort 1) and 1 year after physician training (cohort 2). Eligible cases with excessive or inappropriate steroid use were identified, along with any associated risk factors. Results: Data were collected dur-ing May 2018-July 2019 from patients with Crohn's disease (CD) and ulcerative colitis (UC) in cohort 1 (n =1,685) and cohort 2 (n = 1,649). At baseline, 155 patients (9.2%) had received steroids within the previous 12 months, 46 (29.7%) of whom had used steroids excessively, 16 (34.8%) of these having inappropriately used excessive steroids. Although steroid exposure was similar in cohort 1 (9.2%) and cohort 2 (9.7%), the latter comprised fewer excessive steroid users (20.0% vs. 29.7%). Severe disease was associated with excessive steroid use in cases with UC, but not with CD. Conclusions: Although, overall steroid use was rela-tively low in South Korean patients with IBD, one-third of steroid users used them excessively, and one-third among these used excessive steroids inappropriately. High disease activity was the main risk factor for excessive steroid use which may potentially be reduced by physician education, especially in cases with UC. Active screening to minimize excessive and inappropriate ste-roid use through physician education should be considered.
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