Forecasting the Future: A Trek through the Changing Landscape of Inflammatory Bowel Disease

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dc.contributor.advisorKaplan, Gilaad G.
dc.contributor.advisorClement, Fiona M.
dc.contributor.authorCoward, Stephanie
dc.contributor.committeememberMcBrien, Kerry Alison
dc.contributor.committeememberHazlewood, Glen S.
dc.contributor.committeememberCongly, Stephen E.
dc.date2019-11
dc.date.accessioned2019-06-10T14:48:35Z
dc.date.available2019-06-10T14:48:35Z
dc.date.issued2019-06-06
dc.description.abstractInflammatory bowel disease (IBD) is an immune-mediated disease of the gastrointestinal tract. It imparts a lifelong burden once diagnosed, which can lead to medication reliance, hospitalizations, and surgeries. Previous research has elucidated the current state of knowledge on IBD, but what is missing from the field are analyses of IBD-related outcomes within a specific population, and analyses of what these outcomes mean for the future of IBD in that population.1,2 Therefore, the aim of this thesis is to give an overarching understanding of the current burden of IBD; forecast the future burden; and, illustrate what these findings mean for the future of Canadians and our healthcare systems. Administrative data were used to identify prevalent cases from seven provinces (95% of the Canadian population). In Alberta specifically, prevalent and incident cases were isolated and data on hospitalizations, surgeries, medications, and all-cause mortality data were obtained. Using regression analyses, temporal trends of prevalence, incidence, hospitalization (total, IBD-related, and IBD-specific), surgery, biologics (an expensive medication increasing in popularity for the treatment of IBD), and mortality were analyzed. Data on prevalence from all seven provinces were analyzed and forecasted to 2030. Alberta-specific data were used to forecast incidence to 2030, and hospitalizations and surgeries to 2021. Overall, the prevalence of IBD in Canada is significantly increasing. By 2030, an estimated 402,853 Canadians will be living with IBD. In Alberta, incidence is forecasted to continue to significantly decrease from 2015 through to 2030. Hospitalizations and surgeries have also been significantly decreasing in Alberta and are forecasted to continue decreasing through to 2021. The proportion of patients dispensed biologics has been significantly increasing, which is indicative of an increasing utilization of this medication. Finally, the mortality rate has remained stable. While the decrease of adverse IBD-related outcomes (e.g., hospitalization and surgery) prove to be beneficial for patients with IBD and healthcare systems, the significant increase in the number of people with the disease may still overwhelm the system and inhibit patients from receiving necessary care.en_US
dc.identifier.citationCoward, S. (2019). Forecasting the Future: A Trek through the Changing Landscape of Inflammatory Bowel Disease (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/36627
dc.identifier.urihttp://hdl.handle.net/1880/110486
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectInflammatory Bowel Diseaseen_US
dc.subjectForecastingen_US
dc.subjectIncidenceen_US
dc.subjectPrevalenceen_US
dc.subject.classificationEpidemiologyen_US
dc.subject.classificationMedicine and Surgeryen_US
dc.subject.classificationPublic Healthen_US
dc.titleForecasting the Future: A Trek through the Changing Landscape of Inflammatory Bowel Diseaseen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrue
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