Anemia screening, prevalence, and treatment in pediatric inflammatory bowel disease in the United States, 2010-2014

Research output: Contribution to journalArticle

Abstract

Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

Original languageEnglish (US)
Pages (from-to)152-161
Number of pages10
JournalPediatric Gastroenterology, Hepatology and Nutrition
Volume22
Issue number2
DOIs
StatePublished - Jan 1 2019

Fingerprint

Inflammatory Bowel Diseases
Anemia
Pediatrics
Ulcerative Colitis
Crohn Disease
Iron
Therapeutics
Quality Improvement
Inpatients
Outpatients
Retrospective Studies
Logistic Models
Databases

Keywords

  • Anemia
  • Crohn disease
  • Iron-deficiency
  • Screening
  • Ulcerative colitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hepatology
  • Gastroenterology

Cite this

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title = "Anemia screening, prevalence, and treatment in pediatric inflammatory bowel disease in the United States, 2010-2014",
abstract = "Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85{\%} of CD and 81{\%} of UC were screened for anemia. Among those screened, 51{\%} with CD and 43{\%} with UC had anemia. Only 24{\%} of anemia patients with CD and 20{\%} with UC were tested for iron deficiency; 85{\%} were iron deficient. Intravenous (IV) iron was used to treat 4{\%} of CD and 4{\%} UC patients overall and 8{\%} of those with anemia. Conclusion: At least 80{\%} of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43{\%}-50{\%} prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.",
keywords = "Anemia, Crohn disease, Iron-deficiency, Screening, Ulcerative colitis",
author = "Steven Miller and Carmelo Cuffari and Eboselume Akhuemonkhan and Guerrerio, {Anthony L} and Lehmann, {Harold P} and Susan Hutfless",
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T1 - Anemia screening, prevalence, and treatment in pediatric inflammatory bowel disease in the United States, 2010-2014

AU - Miller, Steven

AU - Cuffari, Carmelo

AU - Akhuemonkhan, Eboselume

AU - Guerrerio, Anthony L

AU - Lehmann, Harold P

AU - Hutfless, Susan

PY - 2019/1/1

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N2 - Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

AB - Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

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