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

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

• Kim ES
• Lee YJ
• Jang BI
• Kim KO
• Kim EY
• Lee HS
• Jeon SW
• Kwak SG
• on behalf of Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)

• KMID: 2420002
• DOI: http://doi.org/10.3904/kjim.2016.387

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

Keyword

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

MeSH Terms

Ambulatory Care
Ambulatory Care Facilities
Crohn Disease
Humans
Necrosis
Risk Factors
Tertiary Care Centers