Individualized home-monitoring of disease activity in adult patients with inflammatory bowel disease can be recommended in clinical practice: A randomized-clinical trial

Autor: Petra Weimers, Dorte Marker, Johan Burisch, Sanaz Saboori, Kristine Paridaens, Dorit Vedel Ankersen, Pia Munkholm, Mette Bennedsen
Rok vydání: 2019
Předmět:
Glucocorticoids/therapeutic use
Male
Disease
Crohn Disease/diagnosis
Inflammatory bowel disease
Severity of Illness Index
law.invention
Feces
Randomized controlled trial
Quality of life
Crohn Disease
Interquartile range
law
Recurrence
Medicine
Mass Screening
Disease activity
Electronic health
Screening procedures
Gastroenterology
General Medicine
Middle Aged
Immunologic Factors/therapeutic use
Telemedicine
Randomized Clinical Trial
Telemedicine/instrumentation
Disease Progression
Screening
Female
Biological Products/therapeutic use
Internet-Based Intervention
Adult
medicine.medical_specialty
Mass Screening/instrumentation
Colitis
Ulcerative/diagnosis
Medication Adherence
Feces/chemistry
Internal medicine
eHealth
Humans
Immunologic Factors
Glucocorticoids
Biological Products
business.industry
medicine.disease
Quality of Life
Colitis
Ulcerative
Leukocyte L1 Antigen Complex/analysis
Calprotectin
business
Leukocyte L1 Antigen Complex
Program Evaluation
Zdroj: World Journal of Gastroenterology
Ankersen, D V, Weimers, P, Marker, D, Bennedsen, M, Saboori, S, Paridaens, K, Burisch, J & Munkholm, P 2019, ' Individualized home-monitoring of disease activity in adult patients with inflammatory bowel disease can be recommended in clinical practice : A randomized-clinical trial ', World Journal of Gastroenterology, vol. 25, no. 40, pp. 6158-6171 . https://doi.org/10.3748/wjg.v25.i40.6158
ISSN: 2219-2840
DOI: 10.3748/wjg.v25.i40.6158
Popis: BACKGROUND: The optimal way to home-monitor patients with inflammatory bowel disease (IBD) for disease progression or relapse remains to be found.AIM: To determine whether an electronic health (eHealth) screening procedure for disease activity in IBD should be implemented in clinical practice, scheduled every third month (3M) or according to patient own decision, on demand (OD).METHODS: Adult IBD patients were consecutively randomized to 1-year open-label eHealth interventions (3M vs OD). Both intervention arms were screening for disease activity, quality of life and fatigue and were measuring medical compliance with the constant care web-application according to the screening interventions OD or 3M. Disease activity was assessed using home measured fecal calprotectin (FC) and a disease activity score.RESULTS: In total, 102 patients were randomized (n = 52/50 3M/OD) at baseline, and 88 patients completed the 1-year study (n = 43 3M; n = 45 OD). No difference in the two screening procedures could be found regarding medical compliance (P = 0.58), fatigue (P = 0.86), quality of life (P = 0.17), mean time spent in remission (P > 0.32), overall FC relapse rates (P = 0.49), FC disease courses (P = 0.61), FC time to a severe relapse (P = 0.69) and remission (P = 0.88) during 1 year. Median (interquartile range) numbers of FC home-monitoring test-kits used per patient were significantly different, 3M: 6.0 (5.0-8.0) and OD: 4.0 (2.0-9.0), P = 0.04.CONCLUSION: The two eHealth screening procedures are equally good in capturing a relapse and bringing about remission. However, the OD group used fewer FC home test-kits per patient. Individualized screening procedures can be recommended for adult IBD patients in clinical web-practice.
Databáze: OpenAIRE
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