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KMID : 0988920090070010041
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Intestinal Research
2009 Volume.7 No. 1 p.41 ~ p.46
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Inter-Physician Variation in Treatment for Patients with Crohn’s Disease
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Choi Hwang
Kim Min-Kuk
Kim Hyung-Keun
Ji Jeong-Seon
Choi Myung-Gyu
Choi Gyu-Yong
Chung In-Sik
Kim Sang-Woo
Jung Hyun-Jung
Cheung Dae-Young
Park Soo-Heon
Lee Kang-Moon
Lee Bo-In
Chae Hiun-Suk
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Abstract
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Background/Aims: The incidence and prevalence of Crohn’s disease are increasing in Korea. However, the
guidelines for the management of Crohn’s disease have not been established in Korea. In the current study we determined the difference in the treatment methods between physicians in Korea for Crohn’s disease.
Methods: We retrospectively analyzed the use of medical and surgical treatment modalities in 92 patients with newly diagnosed Crohn’s disease. We compared the treatment strategies among 4 physicians at 3 different institutions.
Results:Prednisone, 5-aminosalicylates, antibiotics, immunomodulators, infliximab, and surgery were prescribed or preformed in 64%, 92%, 24%, 35%, 9%, and 22% of the patients, respectively. The surgical procedures included 12 bowel resections and 8 fistulectomies. The prescription rates for 5-aminosalicylates, prednisone, antibiotics, and infliximab did not differ, but of the use of immunomodulators was significantly different between physicians (p=0.012). The mean interval between diagnosis and the start of immunomodulators was 14 months, and was not different between physicians. The median dosage of immunomodulators was 50 mg per day, and was not different between physicians.
Conclusions: A difference in medical treatment strategies for Crohn’s disease between physicians exists in Korea. Specifically, there was a significant difference in the use of immunodulators between physicians. The development of treatment guidelines for Crohn’s disease, together with efforts to decrease the inter-physician difference for treating
Crohn’s disease are needed.
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KEYWORD
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Crohn Disease, Immunologic Factors, Therapeutics
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