Aintabi Daniel, Greenberg Gillian, Berinstein Jeffrey A, DeJonckheere Melissa, Wray Daniel, Sripada Rebecca K, Saini Sameer D, Higgins Peter D R, Cohen-Mekelburg Shirley
Department of Internal Medicine, St. Joseph Mercy Health System, Ypsilanti, MI, USA.
Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan, USA.
Crohns Colitis 360. 2024 May 3;6(2):otae032. doi: 10.1093/crocol/otae032. eCollection 2024 Apr.
We recently showed that CAPTURE-inflammatory bowel disease (IBD)-a care coordination intervention comprised of routine remote monitoring of patient-reported outcomes (PRO) and a care coordinator-triggered care pathway-was more effective at reducing symptom burden for patients with IBD compared to usual care. We aimed to understand how patients and care team providers experienced the intervention and evaluate purported mechanisms of action to plan for future implementation.
In this study, 205 patients were randomized to CAPTURE-IBD (n = 100) or usual care(n = 105). We conducted semi-structured interviews with 16 of the 100 participants in the CAPTURE-IBD arm and 5 care team providers to achieve thematic saturation. We used qualitative rapid analysis to generate a broad understanding of experiences, perceived impact, the coordinator role, and suggested improvements.
Findings highlight that the intervention was acceptable and user-friendly, despite concerns regarding increased nursing workload. Both participants and care team providers perceived the intervention as valuable in supporting symptom monitoring, psychosocial care, and between-visit action plans to improve IBD care and health outcomes. However, few participants leveraged the care coordinator as intended. Finally, participants reported that the intervention could be better tailored to capture day-to-day symptom changes and to meet the needs of patients with specific comorbid conditions (eg, ostomies).
Remote PRO monitoring is acceptable and may be valuable in improving care management, promoting tight control, and supporting whole health in IBD. Future efforts should focus on testing and implementing refined versions of CAPTURE-IBD tailored to different clinical settings.
我们最近的研究表明,与常规护理相比,CAPTURE炎症性肠病(IBD)——一种由对患者报告结局(PRO)的常规远程监测和护理协调员触发的护理路径组成的护理协调干预措施,在减轻IBD患者的症状负担方面更有效。我们旨在了解患者和护理团队提供者对该干预措施的体验,并评估其所谓的作用机制,以便为未来的实施制定计划。
在本研究中,205名患者被随机分为CAPTURE-IBD组(n = 100)或常规护理组(n = 105)。我们对CAPTURE-IBD组的100名参与者中的16名以及5名护理团队提供者进行了半结构化访谈,以达到主题饱和。我们使用定性快速分析来全面了解体验、感知影响、协调员角色以及提出的改进建议。
研究结果表明,尽管有人担心护理工作量会增加,但该干预措施是可以接受且用户友好的。参与者和护理团队提供者都认为该干预措施在支持症状监测、心理社会护理以及改善IBD护理和健康结局的就诊间行动计划方面具有价值。然而,很少有参与者按预期利用护理协调员。最后,参与者报告说,该干预措施可以更好地进行调整,以捕捉日常症状变化并满足患有特定合并症(如造口术)患者的需求。
远程PRO监测是可以接受的,并且在改善IBD的护理管理、促进严格控制和支持整体健康方面可能具有价值。未来的努力应集中在测试和实施针对不同临床环境量身定制的CAPTURE-IBD改进版本。