Document Detail


E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided 'Constant-care' approach.
MedLine Citation:
PMID:  21071584     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The natural history of ulcerative colitis requires continuous monitoring of medical treatment via frequent outpatient visits. The European health authorities' focus on e-health is increasing. Lack of easy access to inflammatory bowel disease (IBD) clinics, patients' education and understanding of the importance of early treatment at relapse is leading to poor compliance. To overcome these limitations a randomised control trial 'Constant-care' was undertaken in Denmark and Ireland.
METHODS: 333 patients with mild/moderate ulcerative colitis and 5-aminosalicylate acid treatment were randomised to either a web-group receiving disease specific education and self-treatment via http://www.constant-care.dk or a control group continuing the usual care for 12 months. A historical control group was included to test the comparability with the control group. We investigated: feasibility of the approach, its influence on patients' compliance, knowledge, quality of life (QoL), disease outcomes, safety and health care costs.
RESULTS: 88% of the web patients preferred using the new approach. Adherence to 4 weeks of acute treatment was increased by 31% in Denmark and 44% in Ireland compared to the control groups. In Denmark IBD knowledge and QoL were significantly improved in web patients. Median relapse duration was 18 days (95% CI 10 to 21) in the web versus 77 days (95% CI 46 to 108) in the control group. The number of acute and routine visits to the outpatient clinic was lower in the web than in the control group, resulting in a saving of 189 euro/patient/year. No difference in the relapse frequency, hospitalisation, surgery or adverse events was observed. The historical control group was comparable with the control group.
CONCLUSION: The new web-guided approach on http://www.constant-care.dk is feasible, safe and cost effective. It empowers patients with ulcerative colitis without increasing their morbidity and depression. It has yet to be shown whether this strategy can change the natural disease course of ulcerative colitis in the long term.
Authors:
Margarita Elkjaer; Mary Shuhaibar; Johan Burisch; Yvonne Bailey; Hanne Scherfig; Birgit Laugesen; Søren Avnstrøm; Ebbe Langholz; Colm O'Morain; Elsebeth Lynge; Pia Munkholm
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  59     ISSN:  1468-3288     ISO Abbreviation:  Gut     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-12     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1652-61     Citation Subset:  AIM; IM    
Affiliation:
Digestive Disease Center Herlev Hospital, Medical Section, University of Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Colitis, Ulcerative / economics,  metabolism,  psychology,  therapy*
Denmark
Feasibility Studies
Feces / chemistry
Female
Health Care Costs / statistics & numerical data
Health Knowledge, Attitudes, Practice
Humans
Internet*
Ireland
Leukocyte L1 Antigen Complex / metabolism
Male
Mesalamine / therapeutic use
Middle Aged
Patient Compliance
Patient Education as Topic / methods
Quality of Life
Self Administration
Telemedicine / economics,  methods*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Leukocyte L1 Antigen Complex; 89-57-6/Mesalamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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