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Korean J Intern Med. 2018 Sep;33(5):902-910. doi: 10.3904/kjim.2016.387. Epub 2018 Jan 17.

Disparity in Crohn's disease activity between home and clinics is associated with unscheduled hospital visits due to disease flares.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
2
Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
3
Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
4
Division of Gastroenterology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
5
Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, Korea.

Abstract

BACKGROUND/AIMS:

E-health technologies have been implemented for the management of Crohn's disease (CD). We aimed to identify differences between patient activities at home and at routine clinic visits using a web-based self-reporting CD symptom diary (CDSD) and to determine the impact of this disparity on clinical outcomes.

METHODS:

Patients with CD from three tertiary hospitals were invited to assess their symptoms at least once a week using CDSD. We identified patients who showed disparities in disease activity (high activity at home but normal at the next hospital visit) and evaluated clinical outcomes of these patients such as unscheduled visits due to flares using Kaplan-Meier analyses.

RESULTS:

One hundred and forty-three patients recorded their symptoms weekly for at least 3 consecutive months and were included. Forty-eight patients (33.6%) showed disparate disease activities between at home and at the next outpatient clinic visit. The cumulative risk of unscheduled visits was significantly higher in this disparity group than in the concordant group (p = 0.001). Disparity in activity (p = 0.003), and anti-tumor necrosis factor use (p = 0.002) were independent risk factors of unscheduled visits due to disease flares.

CONCLUSION:

Disparity in disease activity is considerable in CD patients and is related to the risk of unscheduled hospital visit.

KEYWORDS:

Crohn disease; Disease activity; Mobile technology; Patients reporting outcome

PMID:
29334724
PMCID:
PMC6129636
DOI:
10.3904/kjim.2016.387
[Indexed for MEDLINE]
Free PMC Article

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