Canadian Association Of Gastroenterology: Open Letter To Canadians

You’re not alone. One in five Canadians waiting to see a gastroenterologist misses work because of digestive disorders. One in four Canadians waiting to see a gastroenterologist is affected in his or her day-to-day functioning. One in three Canadians waiting to see a gastroenterologist experiences anxiety as a direct result of digestive problems. Canadian gastroenterologists and the Canadian Association of Gastroenterology (CAG) know Canadians have reason to worry. Digestive diseases represent 15% of the total economic burden of Canadian health costs and cause a loss of productivity reaching $1.14 billion annually. That’s more than mental, cardiovascular, respiratory or central nervous system diseases. Meanwhile, Canadians have told Statistics Canada that waiting lists and wait times rank among their top health concerns. Despite the harsh realities surrounding digestive disease, Canadians must wait an inordinate amount of time for gastro-intestinal consultations and access to specialized testing. Case in point: 25% of patients with alarm symptoms, indicators of disease such as cancer, are forced to wait 4 months before their case is seen by a specialist. That’s far longer than the 3 weeks Canadians have told us that they’re willing to wait. Frankly, four months is unacceptable. It is time we got our priorities straight. Surprisingly, in developing its wait list reform of the Canadian health care system, Paul Martin’s government overlooked digestive disease. The Canadian Association of Gastroenterology has sent a call to action to Prime Minister Paul Martin, urging him to include digestive disease as a health-care priority and ensure Canadian patients obtain necessary and timely access to our specialists. Canadian gastroenterologists are already out of the starting block.

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Gastroenterologists release new safety guidelines

In this Oct. 3, 2007, file photo released by the University of Wisconsin Medical School shows a virtual colonoscopy, a 3-D image that was computer-generated from a series of X-rays taken by a CT scanner. (AP Photo/ Courtesy of Dr. Perry J. Pickhardt/ University of Wisconsin Medical School, file)

– Canada’s gastroenterologists have new guidelines on safety and quality indicators to help with the more than 1.6 million procedures performed each year, their association announced Monday. Although the Canadian Association of Gastroenterology has guidelines around credentials and training, there was a void in other areas. “If one looks at the sort of totality of endoscopy service delivery, particularly from a patient point of view — which is access to services, rapid access, high quality services, feedback, and an ability to respond to how they perceive endoscopy service delivery — then there really was nothing in place,” said Dr. David Armstrong, chair of the endoscopy committee and the consensus guideline committee. Endoscopy is used to detect or screen for a number of diseases and involves examining the colon or digestive tract using a long, thin tube with a light and camera attached. Last October, about 6,800 Ottawa residents were sent letters from public health officials after it was found that a non-hospital clinic wasn’t following some procedures involving cleaning and infection prevention. The letters indicated the patients might have been exposed to hepatitis B, hepatitis C or HIV. Armstrong said he likes to think the presence of these guidelines would have made a difference in the Ottawa situation. “That’s really because one of the challenges for endoscopy — and it’s in and out of hospitals — has been that if there isn’t a framework to say how things should be monitored and how they should be delivered, it’s difficult to know how much or how closely to monitor things, and what actually are the standards,” Armstrong said in an interview from Hamilton, where he’s an associate professor of medicine at McMaster University. “So I think guidelines that say what should be monitored and what processes have to be in place really from a patient point of view and knowledge that there are tools available to monitor the way that services are delivered and to use as a basis for quality improvement programs would have made a big difference.” Armstrong indicated that it used to be felt that washing the scope and then doing a manual cleaning was sufficient. “And the trouble is there are times when that isn’t sufficient. It’s also important to ensure that all of the endoscopy manufacturers’ instructions and the automatic cleaning equipment instructions are followed, that there’s regular checks of the equipment and the water supply and the filtration and everything else.” It’s something of an undertaking, he noted. “And so to know that those have to be checked regularly and incorporated into all the other quality processes, I think is going to be key as we go forward — particularly as volumes increase.” The new Consensus Guidelines on Safety and Quality Indicators in Endoscopy were developed by a group of 35 Canadian, European and U.S.-based participants, the association said. They reviewed more than two decades’ worth of research to develop their recommendations. Focus groups and patients in Calgary, Hamilton and Montreal were also involved, and questioned about their concerns around the procedures, Armstrong said. Related Links

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Health Canada Approves HUMIRA® (adalimumab) for the Treatment of Ulcerative Colitis (UC)

There are approximately 233,000 Canadians living with IBD, and 104,000 of them live with UC. Approximately 4,500 new cases of UC are diagnosed every year1. “The Crohn’s and Colitis Foundation of Canada is committed to finding cures for ulcerative colitis and Crohn’s disease,” statesCCFC Chief Executive Officer, Dr. Kevin Glasgow . “While we work on finding cures, we are committed to improving the lives of children and adults affected by inflammatory bowel disease. IBD treatments approved by Health Canada will increase access, provide more treatment options, and improve the quality of life for Canadians living with ulcerative colitis.” Canadians prescribed HUMIRA for UC will have the opportunity to be enrolled in PROGRESS, the HUMIRA support program, which provides a wide range of services including insurance, injection, education and ongoing support. “The approval of HUMIRA for ulcerative colitis is a testament to the growing need for targeted treatments in Canada ,” says Felipe Pastrana , General Manager, AbbVie Canada. “With HUMIRA and with initiatives such as the AbbVie IBD Scholarship Program, we want to empower people living with IBD and provide them with all the right tools to succeed.” HUMIRA is also approved in Canada in adults for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), Crohn’s disease (CD), and psoriasis (Ps), as well as in children aged 4 to 17 years for the treatment of polyarticular juvenile idiopathic arthritis (JIA) and in pediatric patients with Crohn’s disease (CD) 13 to 17 of age, 40kg. 1 The Impact of Inflammatory Bowel Disease in Canada: 2012 Final Report and Recommendations, Crohn’s and Colitis Foundation of Canada. About HUMIRA HUMIRA resembles antibodies normally found in the body. It works by blocking TNF-, a protein that, when produced in excess, plays a central role in the inflammatory responses of many immune-mediated diseases. HUMIRA is one of the most comprehensively studied biologics available. The overall clinical database for HUMIRA spans 15 years across multiple indications, including 71 clinical trials with over 23,000 patients. HUMIRA is approved in 90 countries and used by over 670,000 patients worldwide. Any medicines can have side effects.

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