Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Gastroenterology and Hepatology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands.
Pharmacoepidemiol Drug Saf. 2021 Apr;30(4):520-524. doi: 10.1002/pds.5175. Epub 2020 Dec 1.
To assess the agreement between patient-reported and health care provider-reported medical information in inflammatory bowel disease (IBD).
This multicentre, prospective, event monitoring study enrolled adult Crohn's disease (CD) and ulcerative colitis (UC) patients treated with a biological in four medical centers in the Netherlands. At two-monthly intervals, patients completed questionnaires on biological use, combination therapy and indication. The patient-reported information was compared with their electronic health records (EHRs) and analysed for percentage agreement and Cohen's kappa. A reference population from a prospective IBD registry was used to assess the representativeness of the study population.
In total, 182 patients (female 50.5%, mean age 42.2 years, CD 76.9%) were included in the analysis. At baseline, 51.0% of the patients were prescribed an immunomodulator (43.9% thiopurines, 7.1% methotrexate), and patients were prescribed biologicals as follows: 59.3% infliximab, 30.2% adalimumab, 9.3% vedolizumab, and 1.1% ustekinumab. Agreement on patient-reported indication and biological use was almost perfect (κ = 0.878 and κ = 1.000, respectively); substantial for combination therapy (κ = 0.672). Gender, age, type of IBD, biological use and combination therapy were comparable with the reference population.
Systematic patient-reporting by questionnaires was reliable in retrieving indication and treatment specific information from IBD patients. These results indicate that the use of patient-reporting outcomes in daily IBD practice can ensure reliable information collection.
评估炎症性肠病(IBD)患者报告和医疗保健提供者报告的医学信息之间的一致性。
本多中心、前瞻性、事件监测研究纳入了荷兰四家医疗中心接受生物制剂治疗的成年克罗恩病(CD)和溃疡性结肠炎(UC)患者。每两个月,患者完成一次关于生物制剂使用、联合治疗和适应证的问卷。将患者报告的信息与他们的电子健康记录(EHR)进行比较,并分析百分比一致性和 Cohen's kappa。使用前瞻性 IBD 登记处的参考人群来评估研究人群的代表性。
共纳入 182 例患者(女性占 50.5%,平均年龄 42.2 岁,CD 占 76.9%)进行分析。基线时,51.0%的患者接受了免疫调节剂治疗(43.9%为硫唑嘌呤,7.1%为甲氨蝶呤),患者接受的生物制剂治疗如下:59.3%英夫利昔单抗,30.2%阿达木单抗,9.3%维得利珠单抗,1.1%乌司奴单抗。患者报告的适应证和生物制剂使用的一致性几乎为完美(κ=0.878 和 κ=1.000);联合治疗的一致性为显著(κ=0.672)。性别、年龄、IBD 类型、生物制剂使用和联合治疗与参考人群相当。
通过问卷进行系统的患者报告可以可靠地从 IBD 患者中检索适应证和治疗特异性信息。这些结果表明,在日常 IBD 实践中使用患者报告结局可以确保可靠的信息收集。