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KMID : 0338420180330050902
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The Korean Journal of Internal Medicine
2018 Volume.33 No. 5 p.902 ~ p.910
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Disparity in Crohn’s disease activity between home and clinics is associated with unscheduled hospital visits due to disease flares
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Kim Eun-Soo
Lee Yoo-Jin
Jang Byung-Ik
Kim Kyeong-Ok
Kim Eun-Young
Lee Hyun-Seok
Jeon Seong-Woo
Kwak Sang-Gyu
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Abstract
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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.
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KEYWORD
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Crohn disease, Disease activity, Mobile technology, Patients reporting outcome
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