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Open for public comment: IBS quality indicators

Weigh in on AGA’s new quality metrics.
Doctor typing information on the computer in office
Doctor typing information on the computer in office

The AGA Quality Committee has developed quality indicators for irritable bowel syndrome (IBS) and seeks your input about these statements. Please complete our survey by Nov. 9.

What are quality indicators?

Quality indicators are statements derived from published guidelines and consensus documents that describe appropriate care related to a disease state, from diagnosis to management. Quality indicators provide a framework for providing evidence-based, guideline-supported care and can be used at an individual- or practice-level to measure high-quality care and reduce variations in care. Learn more.

Proposed quality indicators for IBS patients:

All IBS patients
  1. Avoidance of opioids for IBS gastrointestinal pain (may need exceptions for opioids used for non-IBS disorders).
  2. Dietary counseling (increased soluble fiber or low FODMAP) or referral to a dietitian.
  3. Recognition of gut-brain axis such as performance of psychotherapy (e.g. cognitive behavioral therapy) or referral to a psychologist as adjunctive treatment.
  4. Avoidance of colonoscopy in IBS patients (<45 years of age) without alarm features. Alarm features include: family history of colorectal cancer or inflammatory bowel disease, unexplained weight loss, blood in stool, nocturnal diarrhea, iron deficiency anemia.
  1. Testing for celiac disease (tissue transglutaminase IgA) in patients with IBS-D.
  2. Treatment with any of the following medications: eluxadoline, rifaximin*, or tricyclic antidepressants in patients with IBS-D.
  1. Treatment with any of the following medications: linaclotide, lubiprostone*, plecanatide*, tegaserod*c, tenapanor*, or tricyclic antidepressants* in patients with IBS-C.

*Recommendations for these medications are conditional, hence evaluate each patient individually before applying quality indicator.

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