scholarly journals Development and feasibility of a telemonitoring tool with full integration in the electronic medical record: a proof of concept study for patients with inflammatory bowel disease in remission on biological therapy

2020 ◽  
Vol 55 (3) ◽  
pp. 287-293
Author(s):  
Sofie Coenen ◽  
Egon Nijns ◽  
Ellen Weyts ◽  
Patricia Geens ◽  
Bart Van den Bosch ◽  
...  
Author(s):  
Jessica Breton ◽  
Char M Witmer ◽  
Yuchen Zhang ◽  
Maura Downing ◽  
Jamie Stevenson ◽  
...  

Abstract Background Iron deficiency (ID) and anemia are one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD), usually complicating the course both in ulcerative colitis and Crohn’s disease. Despite their high prevalence and significant impact on patients, this particular aspect is still underestimated by clinicians. Although guidelines have been recently published to address this problem, these recommendations do not address pediatric specific concerns and do not provide guidance as to how implement these guidelines in clinical practice. The aims of this quality improvement (QI) initiative were to improve the rates of detection and treatment of anemia in children with IBD. Methods After the creation of a multidisciplinary team of skateholders in IBD and anemia, we launched a multifaceted QI strategy that included the development of a pediatric evidence-based care pathway, utilization of an electronic medical record (EMR)-integrated dashboard to track patients, and generation of an automated provider-based monthly report. Data were collected and graphed into statistical process control charts. Results These key strategies resulted in improved rates of ID screening from 31.7% to 63.6%, in increased treatment rates from 38.2% to 49.9%, and in decreased prevalence of anemia from 35.8% to 29.7%, which was reflected by a greater decline in patients with quiescent disease. Conclusions Quality improvement strategies incorporating the creation of a pediatric evidence-based care pathway with an EMR-supported electronic dashboard were the foundation of a successful intervention in the management of ID and anemia in pediatric IBD. Our positive results demonstrate the potential of QI initiatives using automated technology to assist clinicians in their commitment to provide evidence-based IBD care and enhance patient outcomes.


Gut ◽  
2012 ◽  
Vol 62 (3) ◽  
pp. 387-394 ◽  
Author(s):  
Matti Waterman ◽  
Wei Xu ◽  
Amreen Dinani ◽  
A Hillary Steinhart ◽  
Kenneth Croitoru ◽  
...  

2015 ◽  
Vol 148 (4) ◽  
pp. S-206
Author(s):  
Ashraf A. Almashhrawi ◽  
Fazia A. Mir ◽  
Amin Mahdi ◽  
Anjana Sathyamurthy ◽  
Richard Madsen ◽  
...  

2020 ◽  
Vol 57 (4) ◽  
pp. 491-497
Author(s):  
Adhan Amenomori WU ◽  
Jaqueline Ribeiro de BARROS ◽  
Madhoor RAMDEEN ◽  
Julio Pinheiro BAIMA ◽  
Rogerio SAAD-HOSSNE ◽  
...  

BACKGROUND: Biological therapy and new drugs have revolutionized the treatment of inflammatory bowel disease. Ideally, the choice of medication should be a shared decision with the patient, aiming at greater satisfaction, compliance, and consequently, favorable clinical outcome. OBJECTIVE: This study aims to evaluate patient’s preferences in the choice of their therapy and the factors that influence this choice. METHODS: This cross-sectional study enrolled 101 outpatients with Crohn’s disease or ulcerative colitis. The inclusion criteria were age ≥18 years and no previous exposure to biological therapy. Patients’ preferences were assessed through questions that addressed the preferred mode of administration (oral, subcutaneous, or intravenous) and the factors that determined the choice of medication (efficacy, medical indication, fear of medication, convenience, mode of application, and personal doctors’ indication). RESULTS: The mean age was 43.6±13.5 years, 75.3% were female, and 81.2% were cases of ulcerative colitis. Regarding the mode of administration, the majority of patients preferred oral (87.1%), followed by intravenous (6.93%) and subcutaneous (5.94%) medications. The reasons were “I prefer to take it at home” (42.57%), “I have more freedom” (36.63%), “I don’t like self-application” (29.70%), and “I believe it works better” (19.80%). Younger patients and patients in clinical disease activity preferred intravenous mode compared to the oral route (P<0.05). Doctor’s opinion (98%) was an important factor associated with the medication choice. CONCLUSION: Oral route was the preferred mode of administration and most patients took their physician’s opinion into account in their choice of medication.


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