TOPLINE:<\/h2>\n
In patients with chronic pancreatitis, an evidence-based management algorithm was not superior to standard practice in improving quality of life or reducing pain severity. Although a significant reduction in pain scores was observed, the improvement did not reach the predefined threshold of clinical relevance.<\/p>\n
METHODOLOGY:<\/h2>\n\n- International evidence-based management guidelines in chronic pancreatitis aid patient care but vary in evidence quality and expert consensus, leading to potential adherence issues; whether they improve patient-reported outcomes, including pain and quality of life, remains unclear.<\/li>\n
- Researchers conducted a nationwide stepped-wedge cluster-randomized controlled superiority trial across 26 Dutch centers, subdivided into six cluster groups, to determine the effect of an evidence-based management algorithm on quality of life and pain severity in patients with chronic pancreatitis.<\/li>\n
- The study included 418 patients with chronic pancreatitis (median age, 62.5 years; 67.9% men) who had been receiving care from a gastroenterologist or surgeon and were followed longitudinally for 35 months. Of these, 92 patients had been diagnosed with chronic pancreatitis for 3 years or less at the start of the intervention.<\/li>\n
- The cluster groups delivered current practice for at least 6 months before crossing over at 2-month intervals to the evidence-based management algorithm covering four main domains: lifestyle modification, pancreatic function, nutritional support, and pain management. This algorithm-based care was supported by domain-specific flowcharts, web applications, and educational materials for both patients and physicians.<\/li>\n
- The coprimary outcomes were changes in pain severity, measured using the Izbicki Pain Score (range, 0-100), and quality of life, assessed using the Pancreatitis Quality of Life Instrument (PANQOLI; range, 18-103), with an average difference of 10 points in the Izbicki Pain Score or a mean difference of 10% on the PANQOLI defined as clinically relevant.<\/li>\n<\/ul>\n
TAKEAWAY:<\/h2>\n\n- Implementation of the evidence-based management algorithm resulted in a significant reduction in Izbicki Pain Scores (estimate, -1.72; 97.5% CI, -3.02 to -0.41; P<\/em> < .001), but this did not reach the predefined clinically relevant decrease of 10 points. No significant change was observed in PANQOLI scores with algorithm-guided care.<\/li>\n
- At 12 months post-intervention, median protocol adherence among patients who completed the follow-up period was 68.8%. High adherence (> 75%-100%) was associated with significantly lower Izbicki Pain Scores (estimate, -4.28; 95% CI, -6.63 to -1.94; P<\/em> < .001) and higher PANQOLI scores (estimate, 2.19; 95% CI, 0.65-3.73; P<\/em> = .01).<\/li>\n
- Patients with higher baseline Izbicki Pain Scores experienced the greatest treatment benefit (estimate, -3.97; 95% CI, -5.96 to -1.99; P<\/em> < .001), and those with low baseline quality of life experienced improvement in PANQOLI scores (estimate, 2.38; 95% CI, 1.08-3.68; P<\/em> < .001).<\/li>\n
- Implementation of the evidence-based management algorithm led to improved screening for bone health compared with the standard practice phase, with higher detection rates of osteopenia and osteoporosis.<\/li>\n<\/ul>\n
IN PRACTICE:<\/h2>\n
\u201c[The study] findings highlight both the complexity of, and the need for, dedicated protocol adherence in chronic pancreatitis management,\u201d the authors of the study wrote.<\/p>\n
SOURCE:<\/h2>\n
The study was led by Florence EM de Rijk, MD, Erasmus University Medical Center, Rotterdam, Netherlands. It was published online in The American Journal of Gastroenterology<\/em>.<\/p>\nLIMITATIONS:<\/h2>\n
A clinically important effect was set as a 10% improvement in scores based on earlier studies, but this criterion may have been too strict and could have underestimated the impact of the intervention. Interim analyses of protocol adherence were not performed during the trial, and performance feedback was not provided to healthcare providers.<\/p>\n
DISCLOSURES:<\/h2>\n
The trial received financial support through an unrestricted grant provided by Viatris Global Healthcare Company. Some authors reported being consultants, receiving speaker fees, financial support, or funding to institute from various sources, of whom one author reported receiving speaker fees from Viatris.<\/p>\n
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.<\/em><\/p>\n<\/div>\n<\/div>\n
\n
<<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"
TOPLINE: In patients with chronic pancreatitis, an evidence-based management algorithm was not superior to standard practice in improving quality of life or reducing pain severity. Although a significant reduction in pain scores was observed, the improvement did not reach the predefined threshold of clinical relevance. METHODOLOGY: International evidence-based management guidelines in chronic pancreatitis aid patient […]<\/p>\n","protected":false},"author":1,"featured_media":78757,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_daextam_enable_autolinks":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[2],"tags":[],"class_list":["post-78756","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/diyhaven858.wasmer.app\/wp-content\/uploads\/2026\/04\/dt-251008-inflamed-pancreas-tissue-800x450.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/comments?post=78756"}],"version-history":[{"count":0,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media\/78757"}],"wp:attachment":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media?parent=78756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/categories?post=78756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/tags?post=78756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
TAKEAWAY:<\/h2>\n\n- Implementation of the evidence-based management algorithm resulted in a significant reduction in Izbicki Pain Scores (estimate, -1.72; 97.5% CI, -3.02 to -0.41; P<\/em> < .001), but this did not reach the predefined clinically relevant decrease of 10 points. No significant change was observed in PANQOLI scores with algorithm-guided care.<\/li>\n
- At 12 months post-intervention, median protocol adherence among patients who completed the follow-up period was 68.8%. High adherence (> 75%-100%) was associated with significantly lower Izbicki Pain Scores (estimate, -4.28; 95% CI, -6.63 to -1.94; P<\/em> < .001) and higher PANQOLI scores (estimate, 2.19; 95% CI, 0.65-3.73; P<\/em> = .01).<\/li>\n
- Patients with higher baseline Izbicki Pain Scores experienced the greatest treatment benefit (estimate, -3.97; 95% CI, -5.96 to -1.99; P<\/em> < .001), and those with low baseline quality of life experienced improvement in PANQOLI scores (estimate, 2.38; 95% CI, 1.08-3.68; P<\/em> < .001).<\/li>\n
- Implementation of the evidence-based management algorithm led to improved screening for bone health compared with the standard practice phase, with higher detection rates of osteopenia and osteoporosis.<\/li>\n<\/ul>\n
IN PRACTICE:<\/h2>\n
\u201c[The study] findings highlight both the complexity of, and the need for, dedicated protocol adherence in chronic pancreatitis management,\u201d the authors of the study wrote.<\/p>\n
SOURCE:<\/h2>\n
The study was led by Florence EM de Rijk, MD, Erasmus University Medical Center, Rotterdam, Netherlands. It was published online in The American Journal of Gastroenterology<\/em>.<\/p>\nLIMITATIONS:<\/h2>\n
A clinically important effect was set as a 10% improvement in scores based on earlier studies, but this criterion may have been too strict and could have underestimated the impact of the intervention. Interim analyses of protocol adherence were not performed during the trial, and performance feedback was not provided to healthcare providers.<\/p>\n
DISCLOSURES:<\/h2>\n
The trial received financial support through an unrestricted grant provided by Viatris Global Healthcare Company. Some authors reported being consultants, receiving speaker fees, financial support, or funding to institute from various sources, of whom one author reported receiving speaker fees from Viatris.<\/p>\n
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.<\/em><\/p>\n<\/div>\n<\/div>\n
\n
<<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"
TOPLINE: In patients with chronic pancreatitis, an evidence-based management algorithm was not superior to standard practice in improving quality of life or reducing pain severity. Although a significant reduction in pain scores was observed, the improvement did not reach the predefined threshold of clinical relevance. METHODOLOGY: International evidence-based management guidelines in chronic pancreatitis aid patient […]<\/p>\n","protected":false},"author":1,"featured_media":78757,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_daextam_enable_autolinks":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[2],"tags":[],"class_list":["post-78756","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/diyhaven858.wasmer.app\/wp-content\/uploads\/2026\/04\/dt-251008-inflamed-pancreas-tissue-800x450.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/comments?post=78756"}],"version-history":[{"count":0,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media\/78757"}],"wp:attachment":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media?parent=78756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/categories?post=78756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/tags?post=78756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
IN PRACTICE:<\/h2>\n
\u201c[The study] findings highlight both the complexity of, and the need for, dedicated protocol adherence in chronic pancreatitis management,\u201d the authors of the study wrote.<\/p>\n
SOURCE:<\/h2>\n
The study was led by Florence EM de Rijk, MD, Erasmus University Medical Center, Rotterdam, Netherlands. It was published online in The American Journal of Gastroenterology<\/em>.<\/p>\n A clinically important effect was set as a 10% improvement in scores based on earlier studies, but this criterion may have been too strict and could have underestimated the impact of the intervention. Interim analyses of protocol adherence were not performed during the trial, and performance feedback was not provided to healthcare providers.<\/p>\n The trial received financial support through an unrestricted grant provided by Viatris Global Healthcare Company. Some authors reported being consultants, receiving speaker fees, financial support, or funding to institute from various sources, of whom one author reported receiving speaker fees from Viatris.<\/p>\n This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.<\/em><\/p>\n<\/div>\n<\/div>\n TOPLINE: In patients with chronic pancreatitis, an evidence-based management algorithm was not superior to standard practice in improving quality of life or reducing pain severity. Although a significant reduction in pain scores was observed, the improvement did not reach the predefined threshold of clinical relevance. METHODOLOGY: International evidence-based management guidelines in chronic pancreatitis aid patient […]<\/p>\n","protected":false},"author":1,"featured_media":78757,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_daextam_enable_autolinks":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[2],"tags":[],"class_list":["post-78756","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/diyhaven858.wasmer.app\/wp-content\/uploads\/2026\/04\/dt-251008-inflamed-pancreas-tissue-800x450.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/comments?post=78756"}],"version-history":[{"count":0,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/posts\/78756\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media\/78757"}],"wp:attachment":[{"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/media?parent=78756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/categories?post=78756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/diyhaven858.wasmer.app\/index.php\/wp-json\/wp\/v2\/tags?post=78756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}LIMITATIONS:<\/h2>\n
DISCLOSURES:<\/h2>\n
\n
<<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"