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

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  • WJG-25-6158

    Final published version, 3.28 MB, PDF document

  • Dorit Vedel Ankersen
  • Petra Weimers
  • Dorte Marker
  • Mette Bennedsen
  • Sanaz Saboori
  • Kristine Paridaens
  • Johan Burisch
  • Munkholm, Pia

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.

Original languageEnglish
JournalWorld Journal of Gastroenterology
Volume25
Issue number40
Pages (from-to)6158-6171
ISSN1007-9327
DOIs
Publication statusPublished - 2019

    Research areas

  • Adult, Biological Products/therapeutic use, Colitis, Ulcerative/diagnosis, Crohn Disease/diagnosis, Disease Progression, Feces/chemistry, Female, Glucocorticoids/therapeutic use, Humans, Immunologic Factors/therapeutic use, Internet-Based Intervention, Leukocyte L1 Antigen Complex/analysis, Male, Mass Screening/instrumentation, Medication Adherence, Middle Aged, Program Evaluation, Quality of Life, Recurrence, Severity of Illness Index, Telemedicine/instrumentation

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