Evaluation of a vaccination regimen and care in relation to follow-up and treatment of patients with inflammatory bowel disease

Introduction and aims: During the clinical course of inflammatory bowel disease, different causes can compromise kidney, liver, and bone marrow function and increase the risk for osteoporosis, infections, and neoplasias. The aim of the present study was to describe the follow-up of Mexican patients with inflammatory bowel disease in relation to their vaccination regimen, treatment-associated risks, and cancer screening. Materials and methods: A retrospective cross-sectional study was conducted within the time frame of February and June 2017. One hundred patients that had a histopathologic diagnosis of inflammatory bowel disease were surveyed about their follow-up vaccination regimen, treatment-associated risks, and cancer screening. SPSS v24 software was employed for the statistical analysis. Results: One hundred patients with inflammatory bowel disease were studied (90% with ulcerative colitis and 10% with Crohn's disease; 60% women, 40% men): 75% stated that they had no vaccination regimen. A total of 71.4% of the women had at least one Pap smear in their lives and 28.6% did not have them done annually. Twenty-four percent of the patients wore sun block daily. A total of 18.2% of the patients with more than a 10-year progression of ulcerative colitis had an annual colonoscopy. Yearly kidney function was registered in 57.1% of the patients, 92.9% had a yearly complete blood count, and 78.6% had yearly liver function tests. A total of 34.8% of patients had no bone densitometry in their case records. Conclusions: These results are a red flag suggesting the need to reinforce the role of the primary healthcare providers in relation to vaccination follow-up and the need to improve the education of the patient in relation to inflammatory bowel disease. Resumen: Introducción y objetivos: Durante el curso clínico de la enfermedad inflamatoria intestinal (EII) diversas causas pueden comprometer la función renal, hepática y medular e incrementar el riesgo de osteoporosis, infecciones y neoplasias. El objetivo de este estudio es describir el seguimiento que llevan los pacientes mexicanos con EII respecto a su esquema de vacunación, riesgos asociados a tratamiento y cáncer. Material y métodos: Estudio transversal, retrospectivo. Se encuestó a 100 pacientes con diagnóstico histopatológico de EII entre febrero y junio de 2017 acerca del seguimiento de esquema de vacunación, riesgos asociados al tratamiento y cáncer. Se realizó el análisis estadístico en SPSS v. 24. Resultados: Se estudiaron 100 pacientes con EII (el 90% con colitis ulcerosa crónica idiopática, y el 10% con enfermedad de Crohn; el 60% eran mujeres y el 40%, hombres): el 75% negaron poseer un carnet de vacunación; el 71.4% de las mujeres se habían realizado al menos una citometría cervical en su vida, el 28.6% no se la realizan de forma anual; el 24% utilizan protector solar diariamente; el 18.2% con más de 10 años de evolución de una colitis ulcerosa crónica idiopática tiene una colonoscopia anual; anualmente se registra función renal en el 57.1%, biometría hemática en el 92.9%, función hepática en el 78.6% y el 34.8% no tienen densitometría ósea en el expediente. Conclusiones: Estos resultados son un foco rojo que indica la necesidad de reforzar el papel del primer nivel de atención respecto al seguimiento vacunal y la necesidad de mejorar la educación al paciente con relación a la EII. Keywords: Inflammatory bowel disease, Integrated follow-up, Ulcerative Colitis, Crohn's disease, Integral care, Palabras clave: Enfermedad inflamatoria intestinal, Seguimiento integral, Colitis ulcerosa crónica idiopática (CUCI), Enfermedad de Crohn (EC), Cuidado integral