Standardizing Care: Treatment Decisions
Guidelines for the best way to treat inflammatory bowel disease (IBD) strongly recommend against the continued use of steroids for maintenance therapy. This recommendation can be found in the Choosing Wisely Canada campaign for IBD, a national voice for reducing unnecessary tests and treatments in healthcare.
Dr. Karen Kroeker, at the University of Alberta, and Dr. Remo Panaccione and Dr. Cynthia Seow, at the University of Calgary, are using clinical care pathways to ensure all Canadians with IBD receive the same care across the province and to reduce the number of individuals unnecessarily prescribed steroids.
What is a clinical care pathway?
Clinical care pathways (CCP) are standardized, evidence-based management algorithms. A CCP is a created through a combination of the latest research published in journals and expert opinions, ensuring that healthcare providers have access to evidence-informed best practices.
Implementing IBD clinical care pathways in practice can help improve health outcomes and improve communication between healthcare providers and their patients.
Access the National IBD Clinical Care Pathways
Healthcare providers can view or download the national IBD CCPs (weblink). With easy access to these resources, healthcare professionals can stay up to date with the latest best practices in IBD care, ultimately leading to better outcomes for individuals with IBD.
National IBD Clinical Care Pathways Working Group
The National IBD Clinical Care Pathways were developed, reviewed and updated by a group of multidisciplinary experts across Canada. Members included IBD specialists, healthcare providers and patient partners. View current working group members.
Publications
The effect of an electronic medical record-based clinical decision support system on adherence to clinical protocols in inflammatory bowel disease care: Interrupted time series study
Dr. Kroeker and colleagues evaluated the impact of embedding clinical care pathways into electronic medical records. Their analysis showed that this has the potential to improve the adoption of clinical care guidelines and helps to standardize routine care visits for patients with IBD.
Access the publication https://doi.org/10.2196/55314
Declining corticosteroid use for inflammatory bowel disease across Alberta: A population-based cohort study
Dr. Cynthia Seow and colleagues reviewed the use of corticosteroids and anti-TNF therapy in relation to hospitalization and surgery. Their analysis showed that an increase in anti-TNF therapy coincided with a decline in corticosteroid use.
Access the publication https://doi.org/10.1093/jcag/gwac021
Management of inflammatory bowel disease patients with clinical care pathway reduces emergency department utilization
Dr. Richard Fedorak and Dr. Karen Kroeker developed and implemented care pathways for inflammatory bowel disease. This study conducted a retrospective analysis and showed that pathway-managed patients had lower rates of emergency department use at 12 months. This suggests that management with care pathways can be an effective means to improve care.
Access the publication https://doi.org/10.1093/crocol/otaa080
History
In 2016, through the Crohn's and Colitis Canada’s PACE program, Dr. Richard Fedorak and his team in Alberta developed an impressive collection of clinical care pathways, providing healthcare providers with a comprehensive toolkit to treat individuals living with IBD.
In 2020, Dr. Karen Kroeker at the University of Alberta, Dr. Remo Panaccione and Dr. Cynthia Seow at the University of Calgary, in partnership with Crohn’s and Colitis Canada, developed a strategy to nationalize and sustain these pathways to ensure that all Canadians with IBD receive the highest quality care across Canada.
To date, Dr. Kroeker, Dr. Panaccione and Dr. Seow continue to collaborate with leading Canadian IBD experts. Together, they form a working group of interdisciplinary IBD experts who are committed to ensuring that CCPs are regularly reviewed, maintained and updated with the latest evidence and the most effective best practices.
Support the PACE Network
Donations to Crohn’s and Colitis Canada allow the PACE network to carry on its vital work and continue to find solutions to improve IBD care.
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Contact Information
To learn more about the PACE network, please contact research@crohnsandcolitis.ca.
The PACE network is supported by Crohn’s and Colitis Canada and our funding partners: