Department of Gastroenterology, North Zealand University Hospital, Capital Region, Frederikssund, Denmark.
Department of Gastroenterology, Alfred Health and Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2021 Aug;51(8):1207-1211. doi: 10.1111/imj.15132. Epub 2021 Aug 3.
In Denmark, remote monitoring and management of inflammatory bowel disease (IBD) started two decades ago with the web application Constant Care. The disease monitoring in Constant Care consists of simple disease activity questionnaires and home measurement of faecal calprotectin, a stool biomarker for inflammation. It has now been implemented in clinical practice at North Zealand University Hospital in Denmark. Digital health care solutions facilitate remote contact between patients and healthcare providers and have been shown to reduce time to remission, outpatient visits and hospital admissions, and increase adherence to medical therapy, quality of life and disease and treatment knowledge. In Australia, E-Health is an area of increasing interest, particularly given the significant distances travelled by rural patients to access specialist care. There are several foreseeable benefits to incorporating E-Health/remote monitoring into Australian IBD management, including reduced burdens of time and cost on rural patients, and more efficient management of well outpatients, thereby increasing clinic availability for acutely unwell patients. The significant portion of IBD patients managed in private practice in Australia, and the infrastructure within private practice that is well suited to implementation of E-Health makes Australia a viable setting for an E-Health IBD management model like Denmark's Constant Care model. One pilot study is currently underway investigating the feasibility of rapid and remote IBD monitoring and E-Health in an Australian IBD population. The current COVID-19 pandemic has further illustrated the importance of telehealth as a means of maintaining health services to patients in geographic, or social, isolation.
在丹麦,二十年前,通过网络应用程序 Constant Care 开始对炎症性肠病 (IBD) 进行远程监测和管理。在 Constant Care 中,疾病监测包括简单的疾病活动问卷和粪便钙卫蛋白的家庭测量,这是一种炎症的粪便生物标志物。目前,它已在丹麦北日德兰大学医院的临床实践中实施。数字医疗保健解决方案促进了患者和医疗服务提供者之间的远程联系,并已被证明可以缩短缓解时间、减少门诊就诊次数和住院次数,以及提高医疗治疗的依从性、生活质量以及疾病和治疗知识。在澳大利亚,电子健康是一个日益受到关注的领域,特别是考虑到农村患者需要长途跋涉才能获得专科护理。将电子健康/远程监测纳入澳大利亚 IBD 管理有几个可以预见的好处,包括减轻农村患者在时间和费用方面的负担,以及更有效地管理病情稳定的门诊患者,从而为病情突然恶化的患者提供更多的就诊机会。澳大利亚有很大一部分 IBD 患者在私人诊所接受管理,而私人诊所的基础设施非常适合实施电子健康,这使得澳大利亚成为像丹麦的 Constant Care 模式这样的电子健康 IBD 管理模型的可行环境。目前正在进行一项试点研究,调查在澳大利亚 IBD 人群中快速和远程 IBD 监测以及电子健康的可行性。当前的 COVID-19 大流行进一步说明了远程医疗作为向地理隔离或社会隔离的患者提供医疗服务的一种手段的重要性。