Faecal microbiota transplantation for recurrent C. difficile infections: challenges and improvement opportunities for clinical practice and healthcare systems.
| Title: | Faecal microbiota transplantation for recurrent C. difficile infections: challenges and improvement opportunities for clinical practice and healthcare systems. |
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| Authors: | Hocking L; RAND Europe, Cambridge, UK.; Ianiro G; Gastroenterology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.; Leong RW; Macquarie University Hospital and Concord Hospital, Sydney, Australia.; Iqbal T; University of Birmingham, Birmingham, UK.; Kao D; University of Alberta, Edmonton, Alberta, Canada.; Cabling M; RAND Europe, Cambridge, UK.; Stockwell S; RAND Europe, Cambridge, UK.; Romanelli RJ; RAND Europe, Cambridge, UK.; Marjanovic S; RAND Europe, Cambridge, UK. |
| Source: | Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2023 Mar; Vol. 57 (5), pp. 549-564. Date of Electronic Publication: 2022 Dec 10. |
| Publication Type: | Review; Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 8707234 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2036 (Electronic) Linking ISSN: 02692813 NLM ISO Abbreviation: Aliment Pharmacol Ther Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford : Wiley-Blackwell; Original Publication: [Oxford, OX] : Blackwell Scientific Publications, [c1987- |
| MeSH Terms: | Clostridium Infections*/therapy ; Clostridioides difficile*; Fecal Microbiota Transplantation/methods ; Humans ; Feces ; Treatment Outcome ; Delivery of Health Care ; Recurrence |
| Abstract: | Background: There is growing interest in faecal microbiota transplantation (FMT) as a treatment for recurrent Clostridioides difficile infection (CDI), but evidence on the diverse requirements for safe, effective and accessible services is fragmented and limited.; Aims: To identify key components of FMT provision relating to the patient care pathway, stool donor pathway and wider healthcare system, and to explore variation in practice METHODS: We conducted a narrative review of the literature and consultations with key clinical experts in the field. Evidence is drawn from high-income country contexts, with an emphasis on Australia, Canada, Italy and the United Kingdom as case example countries.; Results: We identify and discuss key challenges to do with healthcare capacity (workforce, FMT and stool banking facilities), donors and donations, patient access and choice of FMT delivery routes, regulation, costs and reimbursement. We also identify improvement opportunities to increase awareness of FMT and referral processes, physician training, maintaining patient registries and outcome monitoring metrics, in-country regulatory harmonisation and tackling reimbursement challenges and discuss future research needs.; Conclusion: Effectively bringing FMT to patients in a healthcare system requires much more than just the existence of a clinically effective procedure. With FMT being a potentially effective treatment option for recurrent CDI for many patients, a well-rounded understanding of how appropriate FMT capacity can be built and nurtured is important for both healthcare providers and policymakers seeking to improve patient care.; (© 2022 Ferring International Center SA. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.) |
| Comments: | Comment in: Aliment Pharmacol Ther. 2023 Mar;57(5):585-586. doi: 10.1111/apt.17341.. (PMID: 36786456) |
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| Entry Date(s): | Date Created: 20221210 Date Completed: 20230215 Latest Revision: 20230509 |
| Update Code: | 20260130 |
| DOI: | 10.1111/apt.17309 |
| PMID: | 36495561 |
| Database: | MEDLINE |
Review; Journal Article; Research Support, Non-U.S. Gov't