TY - JOUR

T1 - Individualized home-monitoring of disease activity in adult patients with inflammatory bowel disease can be recommended in clinical practice

T2 - A randomized-clinical trial

AU - Ankersen, Dorit Vedel

AU - Weimers, Petra

AU - Marker, Dorte

AU - Bennedsen, Mette

AU - Saboori, Sanaz

AU - Paridaens, Kristine

AU - Burisch, Johan

AU - Munkholm, Pia

N1 - ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

KW - Adult

KW - Biological Products/therapeutic use

KW - Colitis, Ulcerative/diagnosis

KW - Crohn Disease/diagnosis

KW - Disease Progression

KW - Feces/chemistry

KW - Female

KW - Glucocorticoids/therapeutic use

KW - Humans

KW - Immunologic Factors/therapeutic use

KW - Internet-Based Intervention

KW - Leukocyte L1 Antigen Complex/analysis

KW - Male

KW - Mass Screening/instrumentation

KW - Medication Adherence

KW - Middle Aged

KW - Program Evaluation

KW - Quality of Life

KW - Recurrence

KW - Severity of Illness Index

KW - Telemedicine/instrumentation

U2 - 10.3748/wjg.v25.i40.6158

DO - 10.3748/wjg.v25.i40.6158

M3 - Journal article

C2 - 31686770

VL - 25

SP - 6158

EP - 6171

JO - World Chinese Journal of Digestology

JF - World Chinese Journal of Digestology

SN - 1009-3079

IS - 40

ER -