A Dedicated Pregnancy Clinic Improves Reproductive Knowledge in Inflammatory Bowel Disease

Jogendran, Rohit; Tandon, Pramod; Kroeker, Karen I.; Dieleman, Levinus A.; Huang, Vivian

doi:10.1007/s10620-021-06998-0

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…This suggests that adherence is largely affected by patient-specific factors, which further highlights the importance of ongoing counselling and education in this subset of patients. Although our previous study demonstrated that a dedicated pregnancy clinic improves reproductive knowledge for people with IBD 35 , future work should aim to identify interventions that improve adherence with tight control management in this population. As such, our results suggest that tight control management via remote monitoring may have potential to complement routine clinical care in pregnant people with IBD.…”

Section: Discussionmentioning

confidence: 96%

Optimizing maternal and neonatal outcomes through tight control management of inflammatory bowel disease during pregnancy: a pilot feasibility study

Jogendran

O’Connor

Jeyakumar

et al. 2023

Sci Rep

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A home point-of care FCP test (IBDoc) and a self-reported clinical disease activity program (IBD Dashboard) may improve routine monitoring of IBD activity during pregnancy. We aimed to evaluate the feasibility of tight control management using remote monitoring in pregnant patients with IBD. Pregnant patients (< 20 weeks) with IBD were prospectively enrolled from Mount Sinai Hospital between 2019 and 2020. Patients completed the IBDoc and IBD Dashboard at three core time points. Disease activity was measured clinically using the Harvey–Bradshaw Index (mHBI) for CD and partial Mayo (pMayo) for UC, or objectively using FCP. A feasibility questionnaire was completed in the third trimester. Seventy-seven percent of patients (24 of 31) completed the IBDoc and IBD Dashboard at all core time points. Twenty-four patients completed the feasibility questionnaires. All survey respondents strongly preferred using the IBDoc over standard lab-based testing and would use the home kit in the future. Exploratory analysis identified discordance rates of more than 50% between clinical and objective disease activity. Tight control management using remote monitoring may be feasible among pregnant patients with IBD. A combination of both clinical scores and objective disease markers may better predict disease activity.

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Section: Discussionmentioning

confidence: 96%

Optimizing maternal and neonatal outcomes through tight control management of inflammatory bowel disease during pregnancy: a pilot feasibility study

Jogendran

O’Connor

Jeyakumar

et al. 2023

Sci Rep

Self Cite

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“…Reassuringly, fertility counseling significantly increases consideration of pregnancy by patients with IBD [47]. Thus, patient education is invaluable in combating misinformation and improving reproductive knowledge [49][50][51]. PIDA could reduce childlessness among women who would have otherwise avoided pregnancy due to unfounded fears about their IBD.…”

Section: Discussionmentioning

confidence: 99%

A Novel Decision Aid Improves Quality of Reproductive Decision-Making and Pregnancy Knowledge for Women with Inflammatory Bowel Disease

et al. 2022

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Background Women with inflammatory bowel disease (IBD) with poor IBD-specific reproductive knowledge experience more childlessness and fear of IBD medications in pregnancy. The Pregnancy in IBD Decision Aid (PIDA), developed by an international multidisciplinary team, offers personalized online decision support regarding pregnancy in IBD. Aims Assess the impact of PIDA on quality of reproductive decision-making and pregnancy-related knowledge among preconception (PC) and pregnant patients with IBD, and evaluate acceptability to patients and clinicians. Methods PC and pregnant patients with IBD aged 18–45 completed questionnaires pre- and post-PIDA to assess quality of decision-making (Decisional Conflict Scale (DCS); Decision Self-Efficacy Scale (DSES) and IBD-in-pregnancy knowledge (Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow)). Paired t test assessed for differences pre- and post-PIDA. Patients and clinicians completed acceptability surveys. Results DCS and DSES were completed by 74 patients (42 Crohn’s disease, 32 ulcerative colitis); 41 PC and 33 pregnant. DCS improved significantly post-PIDA in PC patients regarding pregnancy planning (t(40) = 4.83, p < 0.0001, Cohen’s dz = 0.75) and in pregnant patients regarding medication management (t(32) = 2.37, p = 0.0242, dz = 0.41). DSES for PC patients improved significantly post-PIDA (t(40) = -3.56, p = 0.001, dz = -0.56). CCPKnow improved significantly post-PIDA in PC (t(42) = 4.93, p < 0.0001, dz = -0.75) and pregnant patients (t(32) = 5.1, p < 0.0001, dz = -0.89). PIDA was deemed optimal for length, readability, and content amount and considered highly useful by patients (n = 73) and clinicians (n = 14). Conclusions Patients using PIDA developed an improved quality of reproductive decision-making and IBD-in-pregnancy knowledge. PIDA is an accessible tool that can empower women with IBD to make values-congruent, evidence-based decisions regarding pregnancy and may reduce voluntary childlessness.

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“…Patient knowledge of pregnancy-related issues is also central for informed decision making in a complex medical situation [7]. Jogendran et al [8] report on patient knowledge in women attending a dedicated IBD pregnancy clinic who received individualized education. They highlight that attendance at this clinic significantly improved reproductive knowledge.…”

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confidence: 99%

Introduction to the DDS Mini‑Issue: “Inflammatory Bowel Disease and Pregnancy”

Selinger

2022

Dig Dis Sci

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A Dedicated Pregnancy Clinic Improves Reproductive Knowledge in Inflammatory Bowel Disease

Cited by 9 publications

References 26 publications

Optimizing maternal and neonatal outcomes through tight control management of inflammatory bowel disease during pregnancy: a pilot feasibility study

Optimizing maternal and neonatal outcomes through tight control management of inflammatory bowel disease during pregnancy: a pilot feasibility study

A Novel Decision Aid Improves Quality of Reproductive Decision-Making and Pregnancy Knowledge for Women with Inflammatory Bowel Disease

Introduction to the DDS Mini‑Issue: “Inflammatory Bowel Disease and Pregnancy”

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