Jane M Andrews

Jane M Andrews
Central Adelaide LHN · Gastroenterology - General & GI Surgery

MBBS, FRACP, PhD, AGAF

About

498
Publications
45,392
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Introduction
Professor Jane M Andrews is the Medical Lead for Gastroenterology, General & GI Surgery at CALHN, with a longstanding interest in both IBD and FGiD. Her work also examines Healthcare Delivery, Models of Care and the interaction between Mental and Physical Health in GI Conditions. She is on the boards of the Gastroenterological Society of Australia and the research charity Crohn's Colitis Cure and is a member of the management Committee of the Australian and New Zealand IBD Consortium.
Additional affiliations
January 2009 - present
January 2007 - present
University of Adelaide
January 2006 - present
Royal Adelaide Hospital
Education
March 2000
University of Adelaide
Field of study
  • Medicine
January 1987
The University of Sydney
Field of study
  • Medicine

Publications

Publications (498)
Article
Full-text available
Background The thiopurine medications are well established in the treatment of inflammatory bowel disease (IBD). There is significant variation in levels of toxic and therapeutic metabolites. Current data from small or short-term studies support therapeutic drug monitoring (TDM) in assessing azathioprine (AZA) and 6-mercaptopurine (6MP). TDM of thi...
Article
Full-text available
The majority of the Australian public are willing to have a Coronavirus disease 2019 (COVID‐19) vaccination. It is unclear whether people with inflammatory bowel disease (IBD) have the same attitude towards COVID‐19 vaccination. A survey was performed to assess the attitude of patients with IBD towards COVID‐19 vaccination in South Australia. Two‐t...
Article
Background: Diet therapy may bridge the therapeutic gap in ulcerative colitis (UC). Objectives: The novel 4-SURE diet (4-strategies-to-SUlfide-REduction), designed to modulate colonic fermentation and influence production of excess hydrogen sulfide, was examined in a feasibility study for tolerability, clinical efficacy and effects on microbial...
Article
Full-text available
Background Biologic therapies are effective at inducing and maintaining remission in people with inflammatory bowel disease (IBD). Previous studies have associated TNF-a inhibitors with weight gain, however, it is unclear if this is a class-specific effect or a manifestation of good disease control. To clarify this issue, a retrospective study was...
Article
Background: Colorectal adenocarcinoma is an important and preventable complication of inflammatory bowel disease. A previous case series suggested mental health issues and poor engagement in care as novel risk factors. Aims: We sought to confirm the role of patient engagement in care in the development of neoplasia using a case-control methodolo...
Article
Background and Aims Guselkumab, a selective p19 interleukin-23 antagonist, is approved for the treatment of plaque psoriasis and psoriatic arthritis. This study evaluated the efficacy and safety of guselkumab in patients with moderately to severely active Crohn’s disease with inadequate response or intolerance to conventional or biologic therapy....
Article
The gut microbiome has been implicated in the pathogenesis of inflammatory bowel disease (IBD). Studies suggest that the IBD gut microbiome is less diverse than that of the unaffected population, a phenomenon often referred to as dysbiosis. However, these studies have heavily focused on bacteria, while other intestinal microorganisms—fungi, protozo...
Article
Background GALAXI 1 is a Phase 2, double-blind, placebo (PBO)-controlled, multicenter study evaluating efficacy/safety of guselkumab (GUS), a selective IL-23 p19 antagonist, in patients (pts) with moderately to severely active Crohn’s disease (CD) with inadequate response/intolerance to conventional therapies (corticosteroids, immunomodulators) and...
Article
Background Etrolizumab is a gut-targeted anti-β7 integrin monoclonal antibody. In an earlier phase 2 induction study, etrolizumab significantly improved clinical remission relative to placebo in patients with moderately to severely active ulcerative colitis. The HIBISCUS studies aimed to compare the efficacy and safety of etrolizumab to adalimumab...
Preprint
Full-text available
Ulcerative colitis (UC) is a major form of inflammatory bowel disease with increasing global incidence. There is significant phenotypic heterogeneity defined by a range of clinical variables including age of onset and disease extent. Clinical outcomes range from long-term remission on minimal therapy to surgical resection. Close to 70% of UC risk c...
Article
Full-text available
Background Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity. Methods Electronic databases were searched from...
Poster
Full-text available
Reports have suggested anti-TNF therapy such as Infliximab (IFX) is associated with weight gain in immune mediated inflammatory disorders, including Inflammatory bowel disease. We aim to explore different weight trajectories in IFX-treated IBD patients and examine potential characteristics of, and associations with, each weight trajectory subgroup.
Conference Paper
Background and Aim: Biological therapies are effective at inducing and maintaining remission in patients with inflammatory bowel disease (IBD). Previous studies have associated tumor necrosis factor-α inhibitors with weight gain. Contrary to conventional beliefs, about a third of patients with IBD are obese. Undesired weight gain in patients with I...
Conference Paper
Full-text available
Background ‘CCCare’ is an inflammatory bowel disease (IBD)-specific electronic medical record (eMR) developed to support care for adults with IBD. ‘CCCare-P’ is the paediatric ‘version’ of CCCare. CCCare-P may provide coordination of care between paediatric and adult centres during transition. A consensus method, described here, was developed prior...
Article
Full-text available
Background and Aim There is an increasing prevalence of chronic disease worldwide, resulting in multiple management challenges. Inflammatory bowel disease (IBD) is an exemplar chronic disease requiring coordinated longitudinal care. We propose that Crohn's Colitis Care (CCCare), a novel IBD-specific, structured electronic medical record is effectiv...
Article
Background Dietary misconceptions and behaviours may worsen outcomes of inflammatory bowel disease (IBD). This scoping review aims to examine the dietary beliefs and behaviours of individuals with IBD and identify evidence of food avoidance, dietary restriction or disordered eating and any association with quality of life (QoL). Methodology A syst...
Article
Full-text available
Background There is controversy about the proactive clinical application of Therapeutic Drug Monitoring (TDM) of biologic drugs in Crohn’s disease. One way to practically assess this is to examine how TDM influences management decisions. We examined how knowledge of proactive and reactive anti-tumour necrosis factor (anti-TNF) drug levels changes m...
Article
Full-text available
Introduction Perianal fistulising Crohn’s disease (pfCD) can be somewhat treatment refractory. Higher infliximab trough levels (TLIs) may improve fistula healing rates; however, it remains unclear whether escalating infliximab therapy to meet higher TLI targets using proactive, or routine, therapeutic drug monitoring (TDM) improves outcomes. This r...
Article
Full-text available
Background Biologic therapies are effective at inducing and maintaining remission in patients with inflammatory bowel disease (IBD). Previous studies have associated TNF-a inhibitors with weight gain, however it is unclear if this is a class-related effect or a manifestation of clinical remission. We performed this retrospective study to compare we...
Article
Full-text available
Background Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking.1 The influences on FRQoL in people with inflammatory bowel disease (IBD) are not well explored, despite IBD being a chronic disease affecting the digestive tract. This study aimed to characterise and identify any patient or disease-r...
Article
Full-text available
Background Guselkumab (GUS), an IL-23 antagonist, is being investigated for the treatment of IBD. GALAXI 1 is a ph2, double-blind, PBO-controlled study in pts with moderately to severely active CD with inadequate response or intolerance to conventional therapies (corticosteroid, immunosuppressant) and/or biologics (TNF antagonist, vedolizumab). Her...
Article
Full-text available
Background There is an increasing prevalence of chronic disease worldwide, resulting in multiple management challenges. Inflammatory bowel disease (IBD) is an exemplar chronic disease requiring optimal longitudinal coordinated care. We propose that Crohn’s Colitis Care (CCCare), a novel IBD-specific electronic medical record intended to improve IBD...
Article
Background Measuring food-related quality of life (FRQoL) quantifies the psychosocial impact of eating and drinking. FRQoL and associated factors are not well explored in people with inflammatory bowel disease (IBD), despite IBD being a chronic disease affecting the digestive tract. This study aims to characterise and identify any patient or diseas...
Article
Full-text available
Background and Aim Medication nonadherence is common in patients with inflammatory bowel disease (IBD) and has been associated with worse outcomes. The coronavirus disease 2019 (COVID‐19) pandemic led to significant consumer and medical concern regarding the possible risks of immunosuppressive medications during the pandemic. This study aimed to ex...
Article
Background: Thiopurines effectively maintain remission in ulcerative colitis patients. Whether early initiation of thiopurines after ulcerative colitis diagnosis decreases proximal disease progression and colectomy rates is not known. Methods: We conducted a cohort study of ulcerative colitis subjects recruited from 1970 to 2009. Early thiopurin...
Article
Background Dietary fiber may influence disease course in individuals with inflammatory bowel disease (IBD), yet there is a paucity of understanding of habitual fiber intakes. Objectives To identify studies measuring fiber intakes of individuals with IBD, compare the adequacy of fiber intakes with that of control groups or respective national dieta...
Article
Background: Adherence to evidence-based management is variable in inflammatory bowel disease (IBD), which leads to worse patient outcomes and higher healthcare utilization. Solutions include electronic systems to enhance care, but these have often been limited by lack of clinician design input, poor usability, and low perceived value. A cloud-base...
Presentation
Medication non‐adherence among patients with inflammatory bowel disease during the COVID‐19 pandemic is associated with increased disease activity and corticosteroid usage A Barnes1,2, P Spizzo1, J Andrews3,4 and R Mountifield1,2 1Flinders Medical Centre, Adelaide, South Australia, Australia; 2Flinders University, Adelaide, South Australia, Austr...
Article
Full-text available
Background: The impact of pregnancy on levels of biologic agents in patients with IBD is undefined and time to elimination in vedolizumab-exposed infants is unknown. Aims: To determine the effect of pregnancy on infliximab, adalimumab and vedolizumab levels and to study infant vedolizumab clearance METHODS: In a prospective observational study,...
Poster
The negative impact of immune-mediated inflammatory disorders (IMIDs) on patients’ physical health and quality of life (QoL) is well documented. However, the impact of mental health comorbidities on IMID treatment and patient outcome has not been fully characterized. Objective: To evaluate the prevalence of mental health comorbidities, namely dep...
Article
Background: Recommendations for dietary fibre intake in patients with inflammatory bowel disease are highly variable. Despite the potential benefits of prebiotic fibres on the gut microbiome, many patients with inflammatory bowel disease follow a low fibre diet. The present study comprehensively evaluated intakes of total and prebiotic fibres in p...
Article
Full-text available
Association between tumour necrosis alpha inhibitors and weight gain has been reported. We examined weight change in our cohort of inflammatory bowel disease patients treated with infliximab (IFX) for over 12 months, its associations and financial implications. Two-thirds of patients gained weight during the course of therapy. The mean change in we...
Article
Full-text available
Background: Vedolizumab (VDZ), a humanised monoclonal antibody that selectively inhibits alpha4-beta7 integrins is approved for use in adult moderate to severe ulcerative colitis (UC) patients. Aim: To assess the efficacy and safety of VDZ in the real-world management of UC in a large multicenter cohort involving two countries and to identify pr...
Article
Background: Patients with ulcerative colitis (UC) often face complex treatment decisions. Although shared decision making (SDM) is considered important, tools to facilitate this are currently lacking for UC. A recent pilot study of a novel Web-based decision aid (DA), my Actively Informed Decision (myAID), has suggested its acceptability and feasi...
Article
Full-text available
Background and aims: Serial measurements of luminal disease activity may facilitate inflammatory bowel disease management. Gastrointestinal ultrasound is an easily performed, non-invasive alternative to other assessment modes. However, its widespread use is limited by concerns regarding validity, reliability, and responsiveness. We systematically...
Article
The Royal Flying Doctor Service (RFDS) provides medical care to populations without access to traditional health-care services. From 2014 to 2018 the RFDS conducted 6007 (≈1201/year) aeromedical retrievals for gastrointestinal (GI) disorders. More detailed research is needed to determine specific GI disorders that contributed to this caseload, and...
Article
Objective Faecal microbiota transplantation (FMT) has proved to be an extremely effective treatment for recurrent Clostridioides difficile infection, and there is interest in its potential application in other gastrointestinal and systemic diseases. However, the recent death and episode of septicaemia following FMT highlights the need for further a...
Article
Background & aims: Inflammatory bowel diseases (IBD) are associated with high psychosocial burden and economic cost. Integrating psychological care into routine management might lead to savings. We performed a 2-year investigation of the effects of integrated psychological care in reducing healthcare use and costs. Methods: We performed a prospe...
Article
There is little evidence to guide optimal medical and surgical management of the rectal stump in patients undergoing subtotal colectomy (STC) for severe colitis (SC) and acute severe ulcerative colitis (ASUC). All patients undergoing an STC for SC and ASUC at the Royal Adelaide Hospital (RAH), Australia, between 1993 and 2018 were identified and in...
Article
Background and Aims Immunosuppressive therapy is routine for adults with complex active Crohn’s disease (CD), however carries risks, particularly in the setting of sepsis. Exclusive enteral nutrition (EEN) is widely used in paediatric CD, yet efficacy data in adults are sparse. This study evaluated outcomes of EEN in adults with complex active CD....
Article
Background: Quality of care in IBD has received much attention internationally, however, the available surveys focus on health professionals rather than patients. Aims: The study aimed to assess the experiences of health care for people living with inflammatory bowel disease (IBD) against established Australian IBD Standards. Methods: An onlin...
Article
Full-text available
Objectives: To assess the clinical effectiveness of faecal calprotectin (FC) testing for distinguishing between organic gastrointestinal diseases (organic GID), such as inflammatory bowel disease (IBD), and functional gastrointestinal disorders (functional GIDs). Study design: Studies that assessed the accuracy of FC testing for differentiating...
Preprint
BACKGROUND Patients with ulcerative colitis (UC) are often faced with complex treatment decisions. While shared decision making (SDM) is considered important, tools to facilitate this are currently lacking in UC. A recent pilot study of a novel web-based decision aid – my Actively Informed Decision (myAID) – has suggested its acceptability and feas...
Preprint
BACKGROUND Shared decision making (SDM) is becoming an important part of ulcerative colitis (UC) management because of increasing complexity in available treatment choices and their trade-offs. Use of decision aids (DA) may be effective in increasing patients’ participation in their management but their uptake has been limited due to high attrition...
Article
Full-text available
Background Shared decision making (SDM) is becoming an important part of ulcerative colitis (UC) management because of the increasing complexity of available treatment choices and their trade-offs. The use of decision aids (DA) may be effective in increasing patients’ participation in UC management but their uptake has been limited due to high attr...
Article
Full-text available
Background and aim: Data on patient needs and access to psychological services in inflammatory bowel disease (IBD) are scarce. This study aimed to describe the levels of distress and the needs, attitudes, and access to psychological services for people within Australia against established Australian IBD Standards. Methods: An online cross-sectio...
Article
Background and aims: Inflammatory bowel disease is associated with psychosocial issues which reduce quality of life and impair medical management. However, these issues are rarely addressed in routine care. A model of integrated psychological screening and intervention was trialled to measure prevalence, patient participation, and potential benefi...
Article
Background: Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admission and red cell transfusion is frequently required. A large single-centre randomised study from 2013 showed that a restrictive transfusion strategy in UGIB management was associated with better outcomes compared to a liberal strategy. Subsequently multiple inte...
Article
Crohn Disease (CD) is a complex genetic disorder for which more than 140 genes have been identified using genome wide association studies (GWAS). However, the genetic architecture of the trait remains largely unknown. The recent development of machine learning (ML) approaches incited us to apply them to classify healthy and diseased people accordin...
Article
In Reply We agree with Dr Benech and colleagues that, in our trial,¹ ideally both donor and autologous FMT should have been processed under anaerobic conditions. Aerobic stool processing results in loss of many beneficial obligate anaerobic organisms such as Faecalibacterium prausnitzii.² However, ours was an investigator-led trial with limited acc...
Article
Full-text available
Background Active inflammatory bowel disease (IBD) adversely affects pregnancy outcomes. Little is known about the risk of relapse after stopping anti–tumor necrosis factor (anti-TNF) treatment during pregnancy. We assessed the risk of relapse before delivery in women who discontinued anti-TNF treatment before gestational week (GW) 30, predictors o...
Article
Full-text available
Background and Aims Gastrointestinal (GI) adenocarcinoma, especially colorectal cancer (CRC), is a devastating complication of inflammatory bowel disease (IBD). We sought to examine the role of chronic inflammation and other possible predictors of the development of CRC, as well as assess as yet unexamined factors such as psychological comorbidity...
Article
Full-text available
Background: Symptoms of anxiety and depression are common in inflammatory bowel disease (IBD). Antidepressants are taken by approximately 30% of people with IBD. However, there are no current guidelines on treating co-morbid anxiety and depression in people with IBD with antidepressants, nor are there clear data on the role of antidepressants in m...
Article
Full-text available
Background Symptoms of anxiety and depression are common in inflammatory bowel disease (IBD). Antidepressants are taken by approximately 30% of people with IBD. However, there are no current guidelines on treating co-morbid anxiety and depression in people with IBD with antidepressants, nor are there clear data on the role of antidepressants in man...
Article
Background There is no consensus about the optimal management of the rectal stump after an emergency subtotal colectomy in patients with acute severe ulcerative colitis (ASUC). The aim was to perform a systematic review of the published literature on the surgical and medical management of the rectal stump after an emergency (sub) total colectomy in...