Author : Naomi Rose Maas Schwartz
Release : 2021
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Kind : eBook
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Book Synopsis Dietary Therapy for Pediatric Inflammatory Bowel Disease by : Naomi Rose Maas Schwartz
Download or read book Dietary Therapy for Pediatric Inflammatory Bowel Disease written by Naomi Rose Maas Schwartz. This book was released on 2021. Available in PDF, EPUB and Kindle. Book excerpt: The objective of this study was to assess the potential health outcomes and economic impact of the Specific Carbohydrate Diet (SCD) as a therapeutic option for pediatric patients with inflammatory bowel disease (IBD). In Aim 1, we evaluated the comparative effectiveness of the SCD as an adjunct to pharmacotherapy by using registry data to create an external control arm for an N-of-1 trial. In the full population, there was no statistically significant difference in the change in disease activity from baseline to eight weeks comparing the SCD plus pharmacotherapy to pharmacotherapy alone. In subgroup analyses limited to patients with active disease at baseline, the difference in differences in disease activity was statistically significant, but did not reach clinical significance. In Aim 2, we developed a hybrid decision tree Markov model to assess the value-based price (VBP) of the SCD for induction of remission in pediatric patients with active Crohn’s disease (CD). At an effectiveness of only 50%, we found that the VBP of the SCD at a willingness-to-pay threshold of $50,000 per quality-adjusted life year was close to $20,000, which far exceeds the likely cost of the diet. In Aim 3, we conducted a qualitative study of parents of patients with IBD treated at Seattle Children’s Hospital to assess perceived barriers to initiating and/or maintaining the SCD. We found that parents of children diagnosed with IBD primarily chose to try the SCD due to concerns about medication safety. Additionally, we identified that cost, time commitment, and psychosocial impact are three major barriers to utilizing the SCD. This work provides a foundation for further research into the population health and economic impacts of dietary therapy for IBD. Future studies are needed to assess both the direct and indirect costs of the SCD, as well as the effectiveness of the SCD as a stand-alone therapy and as an adjunct to pharmacotherapy. These data would enable more robust evaluation of the SCD as a therapeutic option, therefore providing essential information for clinicians, patients, payers, and policy-makers.