Implementation of the French national consensus for the management of ulcerative colitis into clinical practice

  • Dig Liver Dis. 2016 Dec;48(12):1405-1409. doi: 10.1016/j.dld.2016.08.127.
Guillaume Bonnaud  1 ,  Audrey Haennig  2 ,  Jonathan Levy  3 ,  Nicolas Sigur  3 ,  Alain Ledit  3 ,  Philippe Cabarrot  3 ,  Patrick Faure  4 ,  Catherine Auzimour  5 ,  Asmaa El Atmani  5 ,  Xavier Hebuterne  6 ,  Laurent Peyrin-Biroulet  7
Affiliations
  • 1. Clinique Ambroise Paré, Toulouse, France. Electronic address: [email protected].
  • 2. Clinique Ambroise Paré, Toulouse, France.
  • 3. Clinique des cèdres, Cornebarrieu, France.
  • 4. Clinique Pasteur, Toulouse, France.
  • 5. KPL, Paris, France.
  • 6. Service d'hépato-gastroentérologie, CHU, Nice, France.
  • 7. Service d'hépato-gastroentérologie, CHU, Nancy, France.
PMID: 27697417 DOI: 10.1016/j.dld.2016.08.127
Abstract

Background: Recently, treatment algorithms were developed in France additionally to ECCO recommendations that should be used as reference for Ulcerative Colitis (UC) management. Nevertheless, their implementation in clinical practice remains challenging.

Aims: To evaluate the prevalence of the use of these UC management algorithms in 127 patients followed by private gastroenterologists.

Methods: Charts of all UC patients seen during the year 2015 (n=127) by 10 gastroenterologists were reviewed. The gastroenterologist's management was then compared to the corresponding algorithm situation and, in case of disagreement, analysed by an expert committee.

Results: 94.5% of patients corresponded to a clinical situation described in algorithms. Gastroenterologist's management was adequate to the corresponding algorithm situation in 74.2% of cases. Among the 31 cases of disagreement, the gastroenterologist's decision differed from the algorithm position in 21 cases, and in 76.2% of cases the expert committee would have made the same decision. In the remaining 10 cases, the decision differed from the corresponding algorithm for reasons independent from the gastroenterologist (patient's choice etc.).

Conclusions: French national algorithms for UC management allowed coverage of 95% of clinical cases in real world. In three quarters of cases, these algorithms were strictly followed by private gastroenterologists. Dissemination of these algorithms could optimize and strengthen the practitioner's choice.

Keywords
Decision support; Inflammatory bowel disease; Treatment algorithms.