Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Scand J Gastroenterol. 2021 Jan;56(1):38-45. doi: 10.1080/00365521.2020.1854342. Epub 2020 Dec 7.
Self-monitoring of inflammatory bowel disease (IBD) with the assistant of telemedicine and home-based fecal calprotectin (FC) tests is evolving in the management of IBD. We performed a randomized controlled trial to investigate the compliance and effects of the model IBD-Home in patients with IBD.
Patients were randomized to IBD-Home + standard care ( = 84) or standard care alone ( = 74). Intervention with IBD-Home included IBDoc FC test kits and a digital application used for answering symptom questionnaires (Abbvie/Telia). They were instructed to use these on demand during a 12-month period. Data was collected retrospectively from medical records. Patients who completed the intervention were phoned and asked to answer a survey about the experience of IBD-Home.
The compliance to IBD-Home was low (29%). Women were more compliant compared with men (43% vs 17%, < .001). A significantly higher proportion of patients in the IBD-Home group increased their medical treatment during the study period in comparison to control subjects (33% vs 15% = .007) and there was an association between an increase in treatment and compliance to IBD home (multivariate odds ratio 3.22; 95 confidence interval 1.04 - 9.95). Overall patients reported a positive experience with slight technical difficulties.
Self-monitoring with home based fecal calprotectin and a digital application was found feasible and appreciated by compliers. Compliance to the IBD-Home model was more common in women and associated with an increased treatment for IBD.
通过远程医疗和基于家庭的粪便钙卫蛋白(FC)检测对炎症性肠病(IBD)进行自我监测,这在 IBD 的管理中正在不断发展。我们进行了一项随机对照试验,以调查 IBD-Home 模型在 IBD 患者中的依从性和效果。
患者被随机分配到 IBD-Home+标准护理组(n=84)或仅接受标准护理组(n=74)。IBD-Home 的干预措施包括 IBDoc FC 检测试剂盒和用于回答症状问卷的数字应用程序(Abbvie/Telia)。他们被指示在 12 个月期间按需使用这些。数据从病历中回顾性收集。完成干预的患者被电话联系并要求回答有关 IBD-Home 体验的调查。
IBD-Home 的依从性较低(29%)。与男性相比,女性的依从性更高(43%比 17%,<.001)。与对照组相比,IBD-Home 组中有更高比例的患者在研究期间增加了治疗(33%比 15%,=.007),并且治疗的增加与 IBD 家庭的依从性之间存在关联(多变量优势比 3.22;95%置信区间 1.04-9.95)。总体而言,患者报告说他们的体验是积极的,只有轻微的技术困难。
基于家庭的粪便钙卫蛋白和数字应用的自我监测被发现是可行的,并受到依从者的赞赏。该模型的依从性在女性中更为常见,并且与 IBD 的治疗增加有关。