Poster Presenter

Appropriateness of Crohn's Disease Therapy in Gastroenterological Rehabilitation
Christoph Reichel, Reha Zentrum, Bad Brückenau and Klinik Hartwald
Germany

Background/Aims: The treatment criteria developed by the European Panel on the Appropriateness of Crohn's Disease (CD) Therapy (EPACT) have not been applied in rehabilitation.

Methods: We included the one year patients (n=355) of our in-patient rehabilitation centre with International Classification of Disease Codes for CD. Charts of confirmed CD patients were analyzed according to EPACT criteria. Appropriateness of treatment was assessed in CD categories with frequent treatment changes. Treatment plans were compared to EPACT recommendations.

Results: Charts of 337 proven CD patients (40 ± 11 years, 250 women, Crohn's Disease Activity Index 147 ± 74 Units) were assigned to EPACT types and categories (presence and precision > 90%). The categories steroid-dependent and steroid- refractory were significantly associated with treatment changes in almost 80% of patients. Treatment appropriateness was assessed with all elements in 68 of 72 (94%) encounters in steroid-dependent (n=36) and 40 of 46 (87%) encounters in steroid-refractory patients (n=23). Sixteen out of 132 (12%) treatments were appropriate on admission. The number of differences between treatment plans and EPACT recommendations decreased from 45 to 25 during rehabilitation in both CD categories (P<0.0001).

Conclusions: Our data introduce EPACT criteria as a practical advance towards an optimal therapy in CD rehabilitation.