The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Disparity in Crohn's disease activity between home and clinics is associated with unscheduled hospital visits due to disease flares

  • Kim, Eun Soo (Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Yoo Jin (Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Jang, Byung Ik (Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kim, Kyeong Ok (Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kim, Eun Young (Division of Gastroenterology, Department of Internal Medicine) ;
  • Lee, Hyun Seok (Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Jeon, Seong Woo (Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kwak, Sang Gyu (Department of Medical Statistics, Catholic University of Daegu School of Medicine) ;
  • Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD) (Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD))
  • Received : 2016.11.24
  • Accepted : 2017.04.02
  • Published : 2018.09.01
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Abstract

Background/Aims: E-health technologies have been implemented for the management of Crohn's disease (CD). We aimed to identify differences between patient activities at home and at routine clinic visits using a web-based self-reporting CD symptom diary (CDSD) and to determine the impact of this disparity on clinical outcomes. Methods: Patients with CD from three tertiary hospitals were invited to assess their symptoms at least once a week using CDSD. We identified patients who showed disparities in disease activity (high activity at home but normal at the next hospital visit) and evaluated clinical outcomes of these patients such as unscheduled visits due to flares using Kaplan-Meier analyses. Results: One hundred and forty-three patients recorded their symptoms weekly for at least 3 consecutive months and were included. Forty-eight patients (33.6%) showed disparate disease activities between at home and at the next outpatient clinic visit. The cumulative risk of unscheduled visits was significantly higher in this disparity group than in the concordant group (p = 0.001). Disparity in activity (p = 0.003), and anti-tumor necrosis factor use (p = 0.002) were independent risk factors of unscheduled visits due to disease flares. Conclusions: Disparity in disease activity is considerable in CD patients and is related to the risk of unscheduled hospital visit.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF)

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