Journal article
Retrieval and treatment of patients with primary biliary cholangitis who are lost in the health system
Revista española de enfermedades digestivas, Vol.113(11), pp.776-779
11/01/2021
DOI: 10.17235/reed.2021.8174/2021
PMID: 34470449
Abstract
Introduction: hepatitis C patients loss to follow-up in the health care system has been shown to have negative consequences. This study aimed to investigate this issue as regards primary biliary cholangitis.
Methods: the databases (immunology, biochemistry, clinical reports, drug dispensation, appointments) of 4 reference hospitals in Spain (serving a population of 1,450,000 inhabitants) were analyzed. The diagnosis of primary biliary cholangitis was based on an antimitochondrial antibody titer >= 1:80, chronically elevated alkaline phosphatase, and the absence of other liver disease. Patients were classified as lost in the absence of reports indicating a diagnosis, specific medical follow-up, and/or treatment with bile salts.
Results: a total of 1372 patients with antimitochondrial antibody titers >= 1:80 were included between January 2010 and June 2019. A total of 697 (50.8 %) were classified as having primary biliary cholangitis, and 100 patients (14.3 %; 95 % CI: 11.8-17.2) were identified as lost. Of these, 30 were contacted and retrieved. The median age was 70 years, 93 % were female, median alkaline phosphatase was 185 IU/L, 10 % had pruritus, and 27 % had a transient elastography value > 9.5 kPa. The disease was confirmed and ursodeoxycholic acid was started in all 30 patients. Death was liver-related in 6 of the 100 patients classified as lost.
Conclusion: up to 14.3 % of patients (1 out of 7) with a definitive diagnosis of primary biliary cholangitis remain undiagnosed, thus preventing monitoring and treatment. More than a quarter are at risk of advanced liver disease and its complications. Patients lost in the system must be identified and retrieved, and searching hospital databases is a suitable approach to meet this goal.
Details
- Title: Subtitle
- Retrieval and treatment of patients with primary biliary cholangitis who are lost in the health system
- Creators
- Antonio Olveira-Martin - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainJorge Yebra-Carmona - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainCarla Amaral-Gonzalez - Hosp Univ Canarias, Gastroenterol Dept, Santa Cruz De Tenerife, SpainMarta Tejedor - Hosp Univ Infanta Elena Valdemoro, Gastroenterol Dept, Madrid, SpainPablo Eiras - Hosp Univ Santiago, Gastroenterol Dept, Santiago De Compostela, A Coruna, SpainMaria Hernandez-Perez - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainCarolina Suarez-Cabredo - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainIsabel Spigarelli-de Rabago - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainCristina Suarez-Ferrer - Hosp Univ La Paz, Gastroenterol Dept, Madrid, SpainDalia Morales-Arraez - Hosp Univ Canarias, Gastroenterol Dept, Santa Cruz De Tenerife, SpainInmaculada Chico - Hosp Univ Infanta Elena Valdemoro, Gastroenterol Dept, Madrid, SpainFelicitas Diaz-Flores - Hosp Univ Canarias, Lab Cent, Santa Cruz De Tenerife, SpainRaquel Rodriguez - Hosp Univ Infanta Elena Valdemoro, Gastroenterol Dept, Madrid, SpainSilvia Llorente - Hosp Univ La Paz, Unidad Invest UCICEC, Madrid, SpainEsther Molina-Perez - Hosp Univ Santiago, Gastroenterol Dept, Santiago De Compostela, A Coruna, SpainManuel Nicolas Hernandez-Guerra de Aguilar - Hosp Univ Canarias, Gastroenterol Dept, Santa Cruz De Tenerife, Spain
- Resource Type
- Journal article
- Publication Details
- Revista española de enfermedades digestivas, Vol.113(11), pp.776-779
- Publisher
- Aran Ediciones, S A
- DOI
- 10.17235/reed.2021.8174/2021
- PMID
- 34470449
- ISSN
- 1130-0108
- eISSN
- 2340-4167
- Number of pages
- 4
- Grant note
- Intercept Pharmaceuticals
- Language
- English
- Date published
- 11/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984695681302771
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