Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China.
United European Gastroenterol J. 2023 Dec;11(10):960-972. doi: 10.1002/ueg2.12470. Epub 2023 Nov 3.
Although poor medication adherence has a negative impact on disease prognosis in patients with inflammatory bowel disease (IBD), finding proven solutions remains a challenge. In this study, we developed a telehealth management model based on education and patient-centered medical care (PCEB) using the social media platform WeChat.
To investigate the effect of PCEB on adherence and clinical outcomes.
In this retrospective cohort, 543 IBD patients (274 in the PCEB group and 269 in the routine group) at the IBD center of Renmin Hospital (Wuhan University, Wuhan, China) were enrolled between January 2020 and September 2022. The routine group received routine follow-up and management, while for PCEB patients, a comprehensive IBD education program and PCEB were conducted. Medication adherence and clinical outcomes were also evaluated.
There were no differences between the PCEB and routine groups in terms of patient demographics and clinical characteristics, including disease classification, duration, biological treatment, and educational background at baseline. Compared with routine treatment, PCEB greatly improved patient medication adherence, as assessed by compliance with oral medication, enteral nutrition, biological infusion, and scheduled endoscopic assessment. Clinical and endoscopic remission in patients with PCEB increased during short-term (month 4) and long-term (month 12) follow-ups, along with a decrease in relapse rates for CD (13.3% vs. 31.8%) and UC (19.8% vs. 37.2%).
The telehealth model applied to the PCEB group improved medication adherence and clinical outcomes in patients with IBD. This is a new and powerful solution for the long-term management of this chronic and progressive disease.
尽管炎症性肠病（IBD）患者药物依从性差对疾病预后有负面影响，但仍难以找到有效的解决方案。本研究基于教育和以患者为中心的医疗照护（PCEB），利用社交媒体平台微信开发了一种远程医疗管理模式。
探讨 PCEB 对依从性和临床结局的影响。
本回顾性队列研究纳入了 2020 年 1 月至 2022 年 9 月在人民医院（武汉大学）IBD 中心的 543 例 IBD 患者（PCEB 组 274 例，常规组 269 例）。常规组接受常规随访和管理，而 PCEB 组患者则接受综合 IBD 教育计划和 PCEB。还评估了药物依从性和临床结局。
PCEB 组和常规组在患者人口统计学和临床特征方面没有差异，包括疾病分类、病程、生物治疗和基线教育背景。与常规治疗相比，PCEB 极大地提高了患者的药物依从性，表现在口服药物、肠内营养、生物输注和计划内镜评估的依从性方面。短期（第 4 个月）和长期（第 12 个月）随访中，PCEB 组患者的临床和内镜缓解率增加，CD（13.3% vs. 31.8%）和 UC（19.8% vs. 37.2%）的复发率降低。
应用于 PCEB 组的远程医疗模式提高了 IBD 患者的药物依从性和临床结局。这是一种治疗这种慢性进行性疾病的新的、有力的解决方案。
