• Vithoosharan Sivanathan, Chamara Basnayake, William Connell, Emily Wright, John Nik Ding, Ola Niewadomski, Annalise Stanley, Amy Wilson-O'Brien, Stephanie Fry, Tamie Samyue, Mark Lust, Emma Flanagan, ThompsonAlexander J VAJVDepartment of Medicine, University of Melbourne, Melbourne, Victoria, Australia.Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia., and Michael A Kamm.
• Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
• Intern Med J. 2023 Oct 1; 53 (10): 186618741866-1874.

Backgrounds And AimsInflammatory bowel disease (IBD) affects a growing cohort of elderly patients. Our aim was to compare the quality of care received by elderly patients with IBD with a nonelderly adult IBD population using clinical markers including steroid-free clinical remission.MethodRetrospective audit of all consecutive patients attending a specialist IBD centre over a 1-year period aged >60 (elderly cohort [EC]) and 50 consecutive patients aged 30-45 years (control cohort [CC]). A follow-up survey was completed assessing current symptoms and perceptions of care.ResultsOne hundred thirty-nine patients were evaluated (89 EC, 50 CC). Steroid-free clinical remission was observed less commonly in the EC (58, 64%) compared with the CC (40, 80%) (P < 0.05). Biologics such as infliximab (15% EC vs 36% CC; P < 0.01) and adalimumab (14% EC vs 30% CC; P = 0.02) were used less frequently in the EC, whilst vedolizumab (6% EC vs 6% CC; P = 1) and ustekinumab (3% EC vs 2% CC; P = 1) were used at a similar frequency. Patients in the EC were less likely to have specialist IBD nursing contact (P < 0.01), smoking screening (P < 0.011) or influenza vaccinations (P < 0.006). IBD nurse contact was associated with significantly greater provision of the preventative care measures.ConclusionElderly patients with IBD were less likely to experience steroid-free clinical remission or be prescribed biologics. Elderly patients were less likely to receive education with respect to preventative medicine. The models of care for the elderly need re-evaluation and greater incorporation with the multidisciplinary IBD team.© 2022 Royal Australasian College of Physicians.

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