Sergio Pinto1,2, Erica Loddo1,2, Salvatore Paba1,2, Agnese Favale1,2, Fabio Chicco1,2, Sara Onali1,2, Paolo Usai1,2, Massimo Claudio Fantini3,4. 1. Department of Medical Science and Public Health, Cagliari, University Hospital of Cagliari, University of Cagliari, Cagliari, Italy. 2. Department of Medical Science and Public Health, Gastroenterology Unit, University of Cagliari, Cagliari, Italy. 3. Department of Medical Science and Public Health, Cagliari, University Hospital of Cagliari, University of Cagliari, Cagliari, Italy. massimoc.fantini@unica.it. 4. Department of Medical Science and Public Health, Gastroenterology Unit, University of Cagliari, Cagliari, Italy. massimoc.fantini@unica.it.
Abstract
BACKGROUND AND AIMS: The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn's Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. METHODS: CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. RESULTS: Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. CONCLUSIONS: PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.
BACKGROUND AND AIMS: The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn's Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. METHODS: CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. RESULTS: Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. CONCLUSIONS:PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBDpatients during periods of limited access to outpatient clinics.
Authors: Peter D R Higgins; Gale Harding; Dennis A Revicki; Gary Globe; Donald L Patrick; Kristina Fitzgerald; Hema Viswanathan; Sarah M Donelson; Brian G Ortmeier; Wen Hung Chen; Nancy K Leidy; Kendra DeBusk Journal: J Patient Rep Outcomes Date: 2018-05-30
Authors: Erica J Brenner; Ryan C Ungaro; Richard B Gearry; Gilaad G Kaplan; Michele Kissous-Hunt; James D Lewis; Siew C Ng; Jean-Francois Rahier; Walter Reinisch; Frank M Ruemmele; Flavio Steinwurz; Fox E Underwood; Xian Zhang; Jean-Frederic Colombel; Michael D Kappelman Journal: Gastroenterology Date: 2020-05-18 Impact factor: 22.682
Authors: Eduardo Martin Arranz; Cristina Suarez Ferrer; Laura García Ramírez; Jose Luis Rueda García; María Sánchez-Azofra; Joaquín Poza Cordón; Jesus Noci; Yamile Zabana; Manuel Barreiro-de Acosta; María Dolores Martín-Arranz Journal: Inflamm Bowel Dis Date: 2020-07-17 Impact factor: 5.325
Authors: Jean-Frederic Colombel; Michael D Kappelman; Ryan C Ungaro; Erica J Brenner; Richard B Gearry; Gilaad G Kaplan; Michele Kissous-Hunt; James D Lewis; Siew C Ng; Jean-Francois Rahier; Walter Reinisch; Flávio Steinwurz; Fox E Underwood; Xian Zhang Journal: Gut Date: 2020-10-20 Impact factor: 31.793
Authors: Peter D R Higgins; Gale Harding; Nancy K Leidy; Kendra DeBusk; Donald L Patrick; Hema N Viswanathan; Kristina Fitzgerald; Sarah M Donelson; Marcoli Cyrille; Brian G Ortmeier; Hilary Wilson; Dennis A Revicki; Gary Globe Journal: J Patient Rep Outcomes Date: 2018-05-09