Getting the Best Care
Crohn’s disease and ulcerative colitis are chronic illnesses, meaning that until the scientific community discovers cures, patients will continue living with these diseases. A key component to ensuring the well-being of patients living with a chronic illness is to continuously evolve and improve patient care.
With the support of grants from Crohn's and Colitis Canada, the researchers noted below are diligently working on research projects that focus on discovering and implementing new ways to ensure patients have access to the best care possible.
2018 Grant Recipients
Dr. Maria Ines Pinto-Sanchez | McMaster University
Research: Oral formula in addition to anti-inflammatory corticosteroids for the treatment of Crohn's disease
Exclusive enteral nutrition (EEN) has been used as an alternative to steroids for children with Crohn’s disease but less so in adults.
Dr. Pinto-Sanchez’s research will test whether novel nutritional therapy can help reduce the disease activity and potentially decrease the side effects of corticosteroid treatment in adults living with Crohn’s disease. Dr. Pinto-Sanchez’s research will be the first to test combining EEN with corticosteroid treatment.
Dr. Phillip Karpowicz | University of Windsor
Research: 24-hour timing in the intestine
All human bodies function in 24-hour cycles known as circadian rhythms. Examples of this are our sleep-wake cycles, daily cycles of hormones, and cycles of hunger and digestion. It’s also true for the intestine’s repair cycle.
Dr. Karpowicz seeks to establish a link between circadian rhythms and the health of the intestine to inform clinicians about the best time for therapeutic interventions for people living with IBD. If researchers can identify at what stage of repair the intestine is in, they can better inform clinicians about when to administer drugs or perform surgery.
2017 Grant Recipients
Dr. Geoffrey Nguyen | University of Toronto
Co-investigators: Dr. Deborah Marshall, and Dr Maida Sewitch
Research: Measuring Healthcare Priorities in the Management of Inflammatory Bowel Disease from a Patient Perspective
The rate of IBD in Canada is among the highest in the world with more than a quarter of a million people affected. Various clinical guidelines for IBD have been developed to improve the healthcare provided to IBD patients. However, doctors and patients often have differing opinions of what are the most important goals of treatment. Unfortunately, the patient perspective is not always well-represented in planning healthcare delivery.
Dr. Nguyen’s work plans to use a survey technique called discrete choice experiments that has long been used in commercial industries to determine what aspects of healthcare are most important to patients. Importantly, the survey methods allow sampling of a very large group of IBD patients throughout Canada so that the perspectives are representative of the entire country.
The results of this study will then compare patient perspectives to that of doctors to see where they really differ. This understanding will improve patient-physician communication. Most importantly the results of this study will help policy makers prioritize IBD-related health initiatives that patients feel are most important.
Dr. Reena Khanna | Western University
Co-investigator: Dr. Guangyong Zou
Research: Development of a New Endoscopic Score for Crohn’s Disease
Meaningful clinical trial outcomes can only be obtained if the most clinically- and scientifically-relevant measures are used to assess disease activity. Research to evaluate and optimize the outcome measures used in Crohn’s disease (CD) clinical trials is therefore crucial.
The main objectives of Dr. Khanna’s work is to: develop a novel index for endoscopic assessment of disease activity in CD using statistical methods; assess alternative methods to score ulcers, since these have been shown to predict a response to treatment; compare the reliability of the current endoscopic indices (SES-CD and CDEIS), and the novel index; and to assess their ability to detect changes in disease activity following treatment.
Dr. Khanna expects that a new index that is more reliable and sensitive to detecting change in endoscopic disease activity following treatment will be the end result of the studies proposed in this application.
Dr. Sara Ahola Kohut | The Hospital for Sick Children
Co-investigators: Dr. Anne Griffiths, and Dr. Kevan Jacobson
Research: iPeer2Peer Program: Online peer monitoring for teens with IBD
Inflammatory bowel disease (IBD) is a childhood illness that can make you feel pain, tired, emotionally upset, and make it hard to see friends or do activities you like. When children become teens they start making more choices about their health. Being a part of making choices about your health can help teens get ready to move to an adult healthcare team.
Peer mentoring using the Internet is a new way to help teens with IBD learn to make choices about their health. This study will compare two groups of teens: those who take part in the iPeer2Peer program and those who do not.
The iPeer2Peer program matches teens with IBD with a young adult mentor who has learned to manage their IBD well. The teen and their mentor will talk on Skype video calls every week for 20-30 minutes over 3 months. The teens’ ability to take care of themselves, their confidence, their IBD symptoms, their quality of life, and the extra costs of living with IBD, will be measured before, right after and six months after the iPeer2Peer program has taken place. Quality of life will also be measured in mentors before and after they take part in the program.
This program is new and different because it uses the Internet to connect teens with mentors. The iPeer2Peer program makes learning to take of yourself easier for young people with IBD. This will make living with IBD easier for teens and may reduce costs to the healthcare system.
2016 Grant Recipients
Dr. Geoffrey Nguyen | University of Toronto
Research: Looking at interventions that affect compliance with medication during pregnancy to improve overall outcomes
Women with inflammatory bowel disease (IBD) have a 2-fold increased risk of complications from pregnancy, primarily preterm delivery and delivery of newborns with low birth weight which substantially increase the risk of infant mortality.
Discontinuation of IBD medications during pregnancy increases the risk of active disease which is associated with adverse pregnancy and neonatal outcomes. However, despite most IBD medications being safe, as many as 40% of women with IBD discontinue medication during pregnancy, mostly due to fear of harm to their fetus.
We will investigate an intervention that will include: (1) formal one-on-one counseling and motivational interviewing with an IBD nurse, (2) interactive video-based education materials, and (3) regular monthly telemedicine follow-up visits with the IBD nurse.
Pregnant women with IBD who are in their first trimester and who are seen at the Mount Sinai Hospital’s high risk obstetrics clinics, participating gastroenterology clinics at Toronto’s academic hospitals or the University of Calgary will be recruited into the Counseling to Optimize Adherence in expectant mothers with Inflammatory Bowel Disease (COACH-IBD) Study. We will enroll 150 women over a 2-year period to be randomized in a 2:1 ratio into the intervention group or standard of care group. Follow-up will be until the time of delivery.
We hypothesize that there will be improvement in the primary outcome, self-reported and objectively measured medication adherence. Secondary outcomes will include number of: flares and steroid courses during pregnancy, live birth, preterm delivery, and low birth weight babies, patient trust in physicians, and patient satisfaction.
Dr. Laura Targownik | University of Manitoba
Co-investigators: Dr. Eric Benchimol, Dr. Geoff Nguyen, Dr. Lisa Lix, Dr. Sanjay Murthy, Dr. Kevan Jacobson, Dr. Gregory Rosenfeld, Dr. Cynthia Seow, Dr. Gilaad Kaplan, Dr. Jennifer Jones, Dr. Juan Nicholas Pena-Sanchez, Dr. Charles Bernstein, Dr. Harminder Singh, Dr. Alain Bitton, Dr. Maria Vutcovici, and Dr. Murray Krahn
Research: Linking Population Based Provincial Health Care Utilization Databases to Evaluate Drug Related Outcomes in IBD
Dr. Targownik is studying the effectiveness of the drugs currently prescribed to patients to look for connections between the use of specific drugs and whether their use is linked to reduced IBD-related hospitalizations, operations, and corticosteroid use.
Dr. Targownik is using provincial health records to see how medications for IBD are being used by Canadians. This work will help healthcare professionals determine whether early use of biologics and/or combination therapy are beneficial to patients.
To learn about the completed research projects that we have supported, click here.