Sutton Reed T, Wierstra Kelsey, Bal Jasmin, Ismond Kathleen P, Dieleman Levinus A, Halloran Brendan P, Kroeker Karen I, Fedorak Richard N, Berga Keri-Ann, Huang Vivian W
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada.
J Can Assoc Gastroenterol. 2019 Dec 19;4(1):27-35. doi: 10.1093/jcag/gwz036. eCollection 2021 Feb.
Poor inflammatory bowel disease (IBD)-specific reproductive knowledge is associated with concerns and medication noncompliance. Having shown an educational portal can improve knowledge, we evaluated its effectiveness for addressing IBD patients' reproductive and medication concerns.
Adult IBD participants (aged 18 to 45 years) were invited to access an e-health portal providing information on heritability, fertility, surgery, pregnancy outcomes, delivery, postpartum, and breastfeeding in the context of IBD and IBD medications. At pre-, post-, and 6+-month postintervention, participants completed a questionnaire on IBD-specific pregnancy concerns, medication concerns from the Beliefs About Medicines Questionnaire (BMQ), and medication adherence via the Medication Adherence Rating Scale (MARS). The Wilcoxon signed-rank test was used to compare median differences between scores (95% confidence).
Demographics for 78 (70.3%) participants completing postintervention questionnaires: median age 29.3 (interquartile range: 25.6 to 32.9) years; 54 (69.2%) Crohn's disease; 21 (26.9%) ulcerative colitis; 63 (80.3%) females, 5 (7.9%) pregnant; and 19 (30.2%) previously pregnant. Postintervention, the median number of reproductive concerns decreased from 3 to 1, and remained stable 6+ months later ( < 0.001*). The median BMQ score decreased from 28 to 25, and remained stable 6+ months later ( = 0.032*). Participants adherent to medications increased from 82.4% to 87.8% postintervention ( = 0.099).
Using an e-health portal may potentially reduce IBD-specific reproductive and medications concerns. An e-health portal is feasible as one component of managing IBD patient's reproductive and medication concerns during preconception and pregnancy.
炎症性肠病（IBD）患者特定的生殖知识匮乏与担忧及药物治疗依从性差有关。鉴于已证明一个教育门户网站可提高知识水平，我们评估了其在解决IBD患者生殖及药物治疗相关担忧方面的有效性。
邀请成年IBD参与者（年龄18至45岁）访问一个电子健康门户网站，该网站提供IBD及IBD药物治疗背景下的遗传、生育、手术、妊娠结局、分娩、产后及母乳喂养等方面的信息。在干预前、干预后及干预后6个月以上，参与者完成一份关于IBD特定妊娠担忧的问卷、来自药物信念问卷（BMQ）的药物治疗担忧问卷，以及通过药物治疗依从性评定量表（MARS）评估的药物治疗依从性。采用Wilcoxon符号秩检验比较得分的中位数差异（95%置信区间）。
78名（70.3%）完成干预后问卷的参与者的人口统计学数据：年龄中位数29.3岁（四分位间距：25.6至32.9岁）；54名（69.2%）患有克罗恩病；21名（26.9%）患有溃疡性结肠炎；63名（80.3%）为女性，5名（7.9%）怀孕；19名（30.2%）既往有过怀孕经历。干预后，生殖方面担忧的中位数从3项降至1项，并在6个月以上后保持稳定（<0.001*）。BMQ得分中位数从28分降至25分，并在6个月以上后保持稳定（=0.032*）。干预后坚持服药的参与者从82.4%增至87.8%（=0.099）。
使用电子健康门户网站可能会减少IBD患者特定的生殖及药物治疗相关担忧。作为孕前和孕期管理IBD患者生殖及药物治疗相关担忧的一个组成部分，电子健康门户网站是可行的。
