Background: Anemia is a common but under-recognized complication of inflammatory bowel diseases (IBD). Anemia in IBD is associated with increased resource utilization and reduced quality of life, yet screening and management of anemia among IBD patients is poor. The Crohn’s and Colitis Foundation Anemia Care Pathway (ACP) was developed to provide a practical approach to anemia management for patients with IBD. The aim of this study was to measure the clinical impact of implementation of the ACP. Methods: The study was performed at the Baylor College of Medicine IBD clinic. ACP was implemented using process mapping of current and ideal processes and the Plan-Do-Study-Act model from September 2016 through January 2017. Chart review was performed retrospectively from July 1, 2016 to June 30, 2017 to collect lab and iron therapy data. Analyses were performed at the encounter level on a monthly basis and over the entire study period. Anemia was defined by the World Health Organization: hemoglobin <12 g/dL in women, and <13 g/dL in men. Results: A total of 1428 patient encounters from 908 unique patients were included in the analyses; 30% of patient encounters had anemia, with only 35% of anemic patients on iron therapy. 25% of patients with anemia were on oral iron, while only 8% were on parenteral iron. The prevalence of anemia decreased from 36% in July 2016 to 26% in June 2017 (Figure 1). The prevalence of patients who were anemic on iron therapy increased from 25% to 33%. Rates of screening for anemia did not change over the study period. Conclusion: Implementation of the ACP increased of the proportion of anemic patients on iron therapy and decreased the prevalence of anemia. Anemia was still present in a quarter of patient encounters. Further improvements of implementation of the ACP, including use of population management tools, are still needed and deserve further study.
