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与三级转诊中心的标准护理相比,炎症性肠病患者的远程医疗(TELE-IBD)并不能改善抑郁症状或总体生活质量。

TELEmedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) Does Not Improve Depressive Symptoms or General Quality of Life Compared With Standard Care at Tertiary Referral Centers.

作者信息

Schliep Matthew, Chudy-Onwugaje Kenechukwu, Abutaleb Ameer, Langenberg Patricia, Regueiro Miguel, Schwartz David A, Tracy J Kathleen, Ghazi Leyla, Patil Seema A, Quezada Sandra, Russman Katharine, Horst Sara, Beaulieu Dawn, Quinn Charlene, Jambaulikar Guruprasad, Cross Raymond K

机构信息

School of Medicine, University of Maryland, Baltimore, Maryland, USA.

Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland, Baltimore, Maryland, USA.

出版信息

Crohns Colitis 360. 2020 Jan;2(1):otaa002. doi: 10.1093/crocol/otaa002. Epub 2020 Jan 31.

Abstract

BACKGROUND

Depression is common in patients with inflammatory bowel disease (IBD) and contributes to poor quality of life (QoL). The use of information technology for the remote management of patients with IBD is growing, but little is known about its impact on depressive symptoms (DS) and QoL. We aimed to evaluate the impact of telemedicine on DS and generic QoL in IBD patients.

METHODS

We analyzed data from the Telemedicine for Patients with IBD (TELE-IBD) study. During this 12-month clinical trial, patients were randomized to receive text message-based telemedicine weekly (TELE-IBD W), every other week (TELE-IBD EOW), or to standard care. Depressive symptoms and QoL were assessed over time with the Mental Health Inventory 5 (MHI-5) and the Short Form 12 (SF-12), respectively. We compared the change in MHI-5 and SF-12 (with separate physical (PCS) and mental component summary (MCS) scores) between the study arms.

RESULTS

A total of 217 participants were included in this analysis. After 1 year, there was no significant difference in the change in MHI-5 (TELE-IBD W +3.0 vs TELE-IBD EOW +0.7 vs standard care +3.4; = 0.70), MCS (TELE-IBD W +1.4 vs TELE-IBD EOW +1.0 vs standard care +2.5; = 0.89), and PCS scores (TELE-IBD W +0.4 vs TELE-IBD EOW +0.6 vs standard care +3.7; = 0.06) between the groups.

CONCLUSIONS

Text message-based telemedicine does not improve DS or QoL when compared with standard care in IBD patients treated at tertiary referral centers. Further studies are needed to determine whether telemedicine improves DS or QoL in settings with few resources.

摘要

背景

抑郁症在炎症性肠病(IBD)患者中很常见,且会导致生活质量(QoL)下降。利用信息技术对IBD患者进行远程管理的应用正在增加,但关于其对抑郁症状(DS)和生活质量的影响却知之甚少。我们旨在评估远程医疗对IBD患者抑郁症状和一般生活质量的影响。

方法

我们分析了炎症性肠病患者远程医疗(TELE-IBD)研究的数据。在这项为期12个月的临床试验中,患者被随机分为每周接受基于短信的远程医疗(TELE-IBD W组)、每两周接受一次(TELE-IBD EOW组)或接受标准护理。分别使用心理健康量表5(MHI-5)和简明健康调查问卷12(SF-12)随时间评估抑郁症状和生活质量。我们比较了各研究组之间MHI-5和SF-12(分别有身体(PCS)和心理成分总结(MCS)评分)的变化。

结果

本分析共纳入217名参与者。1年后,各组之间在MHI-5变化(TELE-IBD W组增加3.0,TELE-IBD EOW组增加0.7,标准护理组增加3.4;P = 0.70)、MCS变化(TELE-IBD W组增加1.4,TELE-IBD EOW组增加1.0,标准护理组增加2.5;P = 0.89)和PCS评分变化(TELE-IBD W组增加0.4,TELE-IBD EOW组增加0.6,标准护理组增加3.7;P = 0.06)方面均无显著差异。

结论

在三级转诊中心接受治疗的IBD患者中,与标准护理相比,基于短信的远程医疗并不能改善抑郁症状或生活质量。需要进一步研究以确定在资源匮乏的环境中远程医疗是否能改善抑郁症状或生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/9801968/d21cf22f56f2/otaa002f0001.jpg

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