Vulnerable Patients with Inflammatory Bowel Disease

Abstract

Crohn’s Disease and ulcerative colitis, collectively known as Inflammatory Bowel Disease (IBD), are conditions characterized by inflammation and ulceration of the intestines. This work aims to highlight disparities among vulnerable IBD populations using the OneFlorida Clinical Research Consortium, a data network housing claims and electronic health record information for more than 15 million patients in Florida. A retrospective analysis using data collected between 01/01/2012 and 06/30/2020 was performed using OneFlorida, and patients were identified using diagnosis and pharmacy codes for IBD. 10,578 patients met the inclusion criteria. Healthcare utilization (emergency department visits, inpatient stay, medications, procedures), disease severity (c-reactive protein, white blood cell count, hemoglobin, albumin), and outcomes (i.e., abdominal surgery) were assessed for patients of different ages, gender, ethnicities, races, and locations. Notably, adolescent and young adult (AYA) patients (ages 17-25) use significantly more corticosteroids than both the pediatric and older adult groups (p-values 0.005 and 0.0007). Contrary to prior literature, Hispanic IBD patients used more biologic medications compared to non-Hispanic White patients (p<0.0001), whereas non-Hispanic Black patients used more steroids (p=0.0004). These findings illustrate a need for targeted educational interventions to support these vulnerable populations.