Management of perianal fistulas in Crohn’s disease: An up-to-date review

Marzo, Manuela

doi:10.3748/wjg.v21.i5.1394

Cited by 89 publications

(79 citation statements)

References 88 publications

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“…SDM is accomplished when an informed patient makes a decision in tandem with their clinician [7, 8, 17, 28, 33]. How a patient views the risks and benefits of each option are used when making ‘preference-sensitive decisions’, as may be the case for pCD [7, 8, 17, 28, 33]. Despite this, 6 of the 14 sources failed to mention any benefits of the options reported.…”

Section: Discussionmentioning

confidence: 99%

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Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn’s fistula

et al. 2017

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BackgroundDecision-making in perianal Crohn’s fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD.MethodsA search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch–Kincaid score.ResultsOf the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion (n = 13). The least common surgical intervention reported was proctectomy (n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2–8) and 2.93 ± 0.73 out of 5 (range = 1–5), respectively. The mean reading ease was US college standard.ConclusionsWe found no patient decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a patient tool to assist decision-making in pCD.

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Section: Discussionmentioning

confidence: 99%

“…Up to 30% of patients with CD develop a perianal fistula [3, 5]. Perianal Crohn’s fistula (pCD) is a debilitating manifestation of CD and adversely affects patient quality of life [6–8]. The management of pCD is a challenge for clinicians as there is more than one treatment option [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn’s fistula

et al. 2017

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“…Current online health information relating to pCD and surgery is not a useful asset in aiding patient decisionmaking, as reflected in low DISCERN and IPDAS scores. SDM is accomplished when an informed patient makes a decision in tandem with their clinician [7,8,17,28,33]. How a patient views the risks and benefits of each option are used when making 'preference-sensitive decisions', as may be the case for pCD [7,8,17,28,33].…”

Section: Discussionmentioning

confidence: 99%

“…It is a chronic, relapsing-remitting disease characterised by granulomatous inflammation which can affect any part of the gastrointestinal system [3,4].Up to 30% of patients with CD develop a perianal fistula [3,5]. Perianal Crohn's fistula (pCD) is a debilitating manifestation of CD and adversely affects patient quality of life [6][7][8]. The management of pCD is a challenge for clinicians as there is more than one treatment option [9,10].…”

Section: Introductionmentioning

confidence: 99%

Assessing Internet Based Information Used to Aid Patient Decision Making in Surgery for Perianal Crohn's Fistula

Marshall

Baker

Lee

et al. 2017

International Journal of Surgery

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Background Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. Methods A search of Google TM and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch-Kincaid score. Results Of the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion (n = 13). The least common surgical intervention reported was proctectomy (n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2-8) and 2.93 ± 0.73 out of 5 (range = 1-5), respectively. The mean reading ease was US college standard. Conclusions We found no patient decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a patient tool to assist decision-making in pCD.

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“…Seton removal was always decided by the surgeon, and was performed between 3 weeks and 40 months following placement. Some recent studies suggest that seton removal after complete induction with anti-tumor necrosis factor (TNF)-α, or at least after the fifth dose of infliximab, may be beneficial in terms of a lower recurrence rate [25]. Any combination of seton placement, immunomodulators, and anti-TNF-α seems to achieve better results than seton placement alone [24].…”

Section: Treatment Of Cpcdmentioning

confidence: 99%

Management of complex perianal Crohn’s disease

Aguilera

Ferre‐Aracil

Paredes

et al. 2016

aog

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Patients with Crohn’s disease often develop perianal disease, successfully managed in most cases. However, its most aggressive form, complex perianal disease, is associated with high morbidity and a significant impairment in patients’ quality of life. The aim of this review is to provide an updated approach to this condition, reviewing aspects of its epidemiology, diagnosis and therapeutic alternatives. Emerging treatment options are also discussed. A multidisciplinary assessment of these patients with a coordinated medical and surgical approach is crucial.

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Management of perianal fistulas in Crohn’s disease: An up-to-date review

Cited by 89 publications

References 88 publications

Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn’s fistula

Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn’s fistula

Assessing Internet Based Information Used to Aid Patient Decision Making in Surgery for Perianal Crohn's Fistula

Management of complex perianal Crohn’s disease

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