2905 Adherence to the Crohn's and Colitis Foundation's IBD Anemia Care Pathway: Treatment of Iron Deficiency Anemia in IBD

Abstract

INTRODUCTION: Anemia is the most common systemic complication of inflammatory bowel disease (IBD), with reported prevalence up to 74%. Anemia is associated with worse disease outcome and quality of life. However, anemia in this population is often underdiagnosed and untreated. The Crohn's and Colitis Foundation (CCF) recently published a care pathway for anemia. Our aim was to assess adherence to the CCF's IBD Anemia Care Pathway in treatment of iron deficiency anemia (IDA) at a tertiary referral center in Texas. METHODS: A retrospective chart review including patients 18 years of age and older in our electronic record system with IBD who had a CBC, an outpatient encounter with gastroenterology, and no hospitalizations from 2014-2018. Demographic, laboratory, and anemia treatment was extracted from electronic records. IDA was defined per the CCF anemia care pathway. Active IBD was defined by elevated CRP and/or fecal calprotectin. RESULTS: 341 patients were included in the analysis, 65 (19%) of which had IDA. Of these anemic patients, 43 (66%) had CD and 16 (32%) had UC, with 1 (2%) patients unspecified. 34 (52%) patients had evidence of active IBD, with 3 (9%) receiving IV iron and 10 (29%) receiving oral Fe. In the 31 patients with inactive IBD, 3 (10%) patients received IV iron and 5 (16%) received oral Fe. CONCLUSION: Active IBD is known to decrease enteral iron absorption and current recommendations encourage parenteral treatment of iron deficiency in patients with IDA and active IBD. In this study, we demonstrate that a limited number of patients with active IBD and IDA received recommended parenteral iron. These results demonstrate that system-wide education is needed regarding recommended IDA treatment based on IBD activity. Future studies at our institution aim to improve this trend.