The Relationship Between Adverse Childhood Experiences and Health Care Use in the Manitoba IBD Cohort Study.

Abstract:

BACKGROUND:We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis. METHOD:Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one's life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data. RESULTS:The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs. CONCLUSION:The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.

journal_name

Inflamm Bowel Dis

authors

Witges KM,Bernstein CN,Sexton KA,Afifi T,Walker JR,Nugent Z,Lix LM

doi

10.1093/ibd/izz054

subject

Has Abstract

pub_date

2019-09-18 00:00:00

pages

1700-1710

issue

10

eissn

1078-0998

issn

1536-4844

pii

5421327

journal_volume

25

pub_type

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