Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
PLoS One. 2020 Jun 5;15(6):e0233654. doi: 10.1371/journal.pone.0233654. eCollection 2020.
The disease-related knowledge levels in patients with inflammatory bowel disease (IBD) are important because it could affect the self-management ability and adaptive coping strategies. We set out to determine whether higher levels of disease-related knowledge reduce medical acceleration.
We evaluated the levels of disease-related knowledge in all patients at the time of enrollment for SNUBH IBD cohort using the validated IBD-KNOW questionnaire. Clinical data were prospectively collected and the factors related to step-up therapy were analyzed. Step-up therapy was defined as the new use of corticosteroids, immunomodulators, or biologics after the enrollment.
Between April 2017 and January 2019, 298 patients were enrolled (mean age, 39.8 years; males, 69.5%); 193 patients (64.8%) had ulcerative colitis and 105 (35.2%) had Crohn's disease. The mean disease duration was 35.8 months. During the mean follow-up of 14.7 months, 90 patients (30.2%) underwent step-up therapy and 208 (69.8%) underwent continuous therapy. The prevalence of continuous therapy increased with increasing IBD-KNOW scores (p for trend = 0.019). Cox proportional hazards analysis revealed that high IBD-KNOW scores (≥ 16) (hazards ratio [HR]: 0.498, 95% confidence interval [CI]: 0.276-0.897, p = 0.020) was negatively associated with the step-up therapy.
Higher disease-related knowledge could reduce the requirement of step-up therapy in IBD. The IBD-KNOW score was independently predictive of step-up therapy.
炎症性肠病（IBD）患者的疾病相关知识水平很重要，因为它可能会影响自我管理能力和适应性应对策略。我们旨在确定较高的疾病相关知识水平是否会降低医疗加速。
我们使用经过验证的 IBD-KNOW 问卷评估了 SNUBH IBD 队列中所有患者在入组时的疾病相关知识水平。前瞻性收集临床数据，并分析与升级治疗相关的因素。升级治疗定义为入组后新使用皮质类固醇、免疫调节剂或生物制剂。
2017 年 4 月至 2019 年 1 月期间，共入组 298 例患者（平均年龄 39.8 岁；男性 69.5%）；193 例（64.8%）为溃疡性结肠炎，105 例（35.2%）为克罗恩病。平均疾病病程为 35.8 个月。在平均 14.7 个月的随访期间，90 例（30.2%）患者接受了升级治疗，208 例（69.8%）患者接受了连续治疗。随着 IBD-KNOW 评分的增加，连续治疗的比例增加（趋势 p = 0.019）。Cox 比例风险分析显示，高 IBD-KNOW 评分（≥16）（风险比 [HR]：0.498，95%置信区间 [CI]：0.276-0.897，p = 0.020）与升级治疗呈负相关。
较高的疾病相关知识可能会降低 IBD 升级治疗的需求。IBD-KNOW 评分是升级治疗的独立预测因素。
