Abstract
Late adolescents and young adults (AYA) with inflammatory bowel disease (IBD) are a vulnerable population as they transition to adult healthcare. We aim to provide a real-world data on their healthcare utilization patterns and medication use through a large database.
We performed a retrospective cohort study from 1/1/2012-6/30/2020 using OneFlorida Data-Trust, an electronic health record-based data repository representing over half of the Florida population. Outcomes of interest included demographics, healthcare utilization, medications, and disease severity. Chi-square tests and logistic regression were used to compare the rates of medications use, healthcare utilization, and disease severity by age groups.
The number of patients who met our inclusion criteria was 10578 with 2731 (25.8%) in the 17-25-year-old group. AYA patients had fewer ambulatory visits vs. children (90% vs. 95%; p-value <0.05). AYA patients were admitted more frequently from emergency facilities vs. children (22.3% vs. 10.9%; p-value <0.05). AYA patients received steroids more often than adults and younger patients (48.9% vs. 45.3 vs. 44.3% p-value <0.05, respectively). AYA patients received more narcotic (41.1% vs. 22.3 % p-value <0.05) and antidepressant prescriptions (15.9% vs. 9.5%; p-value <0.05) compared with children. With advancing age, a decrease in biologic use was noted (51% vs. 40% vs. 25.4% p-value <0.05, respectively).
AYA patients with IBD have higher rates of hospital admissions from ED, fewer ambulatory health visits and they receive more steroids compared to children. Our study demonstrates the need for age-specific IBD programs for AYA patients.