The Korean journal of internal medicine

  • 제33권5호
  • /
  • Pages.902-910
  • /
  • 2018
  • /
  • 1226-3303(pISSN)
  • /
  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

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))
  • 투고 : 2016.11.24
  • 심사 : 2017.04.02
  • 발행 : 2018.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

과제정보

연구 과제 주관 기관 : National Research Foundation of Korea (NRF)

참고문헌

  1. Vermeire S, van Assche G, Rutgeerts P. Review article: altering the natural history of Crohn's disease: evidence for and against current therapies. Aliment Pharmacol Ther 2007;25:3-12. https://doi.org/10.1111/j.1746-6342.2006.03215.x
  2. Veloso FT, Ferreira JT, Barros L, Almeida S. Clinical outcome of Crohn's disease: analysis according to the Vienna classification and clinical activity. Inflamm Bowel Dis 2001;7:306-313. https://doi.org/10.1097/00054725-200111000-00005
  3. Sands BE, Ooi CJ. A survey of methodological variation in the Crohn's disease activity index. Inflamm Bowel Dis 2005;11:133-138. https://doi.org/10.1097/00054725-200502000-00006
  4. Haas L, Maryniuk M, Beck J, et al. National standards for diabetes self-management education and support. Diabetes Care 2013;36 Suppl 1:S100-S108. https://doi.org/10.2337/dc13-S100
  5. Heneghan C, Ward A, Perera R, et al. Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data. Lancet 2012;379:322-334. https://doi.org/10.1016/S0140-6736(11)61294-4
  6. Elkjaer M, Shuhaibar M, Burisch J, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided 'Constant-care' approach. Gut 2010;59:1652-1661. https://doi.org/10.1136/gut.2010.220160
  7. Van Deen WK, van der Meulen-de Jong AE, Parekh NK, et al. Development and validation of an inflammatory bowel diseases monitoring index for use with mobile health technologies. Clin Gastroenterol Hepatol 2016;14:1742-1750. https://doi.org/10.1016/j.cgh.2015.10.035
  8. Kim ES, Park KS, Cho KB, et al. Development of a webbased, self-reporting symptom diary for Crohn's disease, and its correlation with the Crohn's Disease Activity Index: web-based, self-reporting symptom diary for Crohn's Disease. J Crohns Colitis 2017;11:1449-1455.
  9. Jensen RE, Rothrock NE, DeWitt EM, et al. The role of technical advances in the adoption and integration of patient-reported outcomes in clinical care. Med Care 2015;53:153-159. https://doi.org/10.1097/MLR.0000000000000289
  10. Williet N, Sandborn WJ, Peyrin-Biroulet L. Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease. Clin Gastroenterol Hepatol 2014;12:1246-1256. https://doi.org/10.1016/j.cgh.2014.02.016
  11. Ramos-Rivers C, Regueiro M, Vargas EJ, et al. Association between telephone activity and features of patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2014;12:986-994. https://doi.org/10.1016/j.cgh.2013.11.015
  12. Sulz MC, Siebert U, Arvandi M, et al. Predictors for hospitalization and outpatient visits in patients with inflammatory bowel disease: results from the Swiss Inflammatory Bowel Disease Cohort Study. Eur J Gastroenterol Hepatol 2013;25:790-797. https://doi.org/10.1097/MEG.0b013e32836019b9
  13. Nguyen GC, Sheng L, Benchimol EI. Health care utilization in elderly onset inflammatory bowel disease: a population-based study. Inflamm Bowel Dis 2015;21:777-782. https://doi.org/10.1097/MIB.0000000000000306
  14. Gajendran M, Umapathy C, Loganathan P, Hashash JG, Koutroubakis IE, Binion DG. Analysis of hospital-based emergency department visits for inflammatory bowel disease in the USA. Dig Dis Sci 2016;61:389-399. https://doi.org/10.1007/s10620-015-3895-2
  15. Aguas Peris M, Del Hoyo J, Bebia P, et al. Telemedicine in inflammatory bowel disease: opportunities and approaches. Inflamm Bowel Dis 2015;21:392-399. https://doi.org/10.1097/MIB.0000000000000241
  16. Cross RK, Cheevers N, Rustgi A, Langenberg P, Finkelstein J. Randomized, controlled trial of home telemanagement in patients with ulcerative colitis (UC HAT). Inflamm Bowel Dis 2012;18:1018-1025. https://doi.org/10.1002/ibd.21795
  17. Cross RK, Jambaulikar G, Langenberg P, et al. Telemedicine for patients with inflammatory bowel disease (TELEIBD): design and implementation of randomized clinical trial. Contemp Clin Trials 2015;42:132-144. https://doi.org/10.1016/j.cct.2015.03.006
  18. Lazarev M, Huang C, Bitton A, et al. Relationship between proximal Crohn's disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium. Am J Gastroenterol 2013;108:106-112. https://doi.org/10.1038/ajg.2012.389
  19. Gathungu G, Kim MO, Ferguson JP, et al. Granulocytemacrophage colony-stimulating factor autoantibodies: a marker of aggressive Crohn's disease. Inflamm Bowel Dis 2013;19:1671-1680. https://doi.org/10.1097/MIB.0b013e318281f506

피인용 문헌

  1. Clinical usefulness of remote patient monitoring using e-Health technologies in patients with inflammatory bowel diseases vol.33, pp.5, 2018, https://doi.org/10.3904/kjim.2018.298