scholarly journals P142 Systematic review: patient perceptions of monitoring tools in inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S208-S209
Author(s):  
T Goodsall ◽  
R Noy ◽  
T Nguyen ◽  
S Costello ◽  
V Jairath ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Activity ◽  
Patient Preference ◽  
Patient Perceptions ◽  
Monitoring Tool ◽  
Non Invasive ◽  
Activity Assessment ◽  
Monitoring Tools ◽  
Inflammatory Bowel ◽  
Disease Activity Assessment

Abstract Background Management of inflammatory bowel disease (IBD) is directed toward both clinical symptoms as well as objective disease activity as a part of a ‘treat to target’ strategy. Despite the increasing burden of disease activity assessment in IBD, patient preferences for monitoring tools have scarcely been considered. This study aimed to describe the available evidence for patient preference, satisfaction, tolerance and/or acceptability of the available monitoring tools in adults with IBD. Methods A systematic search of Embase, Medline, Pubmed, Cochrane Central and Clinical Trials.gov from January 1980 to April 2019 was conducted using PRISMA best practice guidelines. Included were all study types reporting on the perspectives of adults with confirmed IBD on monitoring tools, where two or more such tools were compared. Outcome measures with summary and descriptive data were presented. Results 10 studies evaluating 1846 participants were included. Study size ranged from 18 to 916 participants. Monitoring tools included venepuncture, stool collection and faecal calprotectin (FC), gastrointestinal ultrasound (GIUS), computed tomography (CT), magnetic resonance imaging (MRI), wireless capsule endoscopy (WCE), barium follow-through, and endoscopy. The measurement tools used were visual analogue scales (VAS), Likert scales or binary preference questions. Outcome domains were patient satisfaction, acceptability of monitoring tool, and patient preference. Meta-analysis was not possible due to heterogeneity of data. Overall, patient preference was for non-invasive tools of disease monitoring and these were associated with a higher level of acceptability. Across all included studies, GIUS was identified by patients as the preferred tool for disease activity assessment. Both FC and other forms of imaging (MRE and CTE) were generally considered preferable to endoscopy, however less so than GIUS. Patient preference for blood testing varied, but in one study was lower than endoscopy. Two studies compared VAS acceptability of multiple IBD monitoring tools. Among 1037 patients, GIUS was considered the most acceptable IBD monitoring tool (mean VAS 9.29), as compared with venepuncture (9.28), WCE (8.5), MRE (8.08), stool collection (7.87), colonoscopy (7.07) and sigmoidoscopy (5.27). Conclusion This is the first systematic review to evaluate patient perceptions of monitoring tools used in IBD. Patients showed a preference for GIUS and more generally for faecal sampling and non-invasive imaging over endoscopy. Further research should address whether clinician selection of more acceptable monitoring tools in IBD engenders greater patient satisfaction, adherence, and a consequent improvement in disease-related outcomes.

scholarly journals Systematic Review: Patient Perceptions of Monitoring Tools in Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Thomas M Goodsall ◽  
Richard Noy ◽  
Tran M Nguyen ◽  
Samuel P Costello ◽  
Vipul Jairath ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Patient Preference ◽  
Bowel Disease ◽  
Patient Perceptions ◽  
Monitoring Tools ◽  
Ultrasound Computed Tomography ◽  
Gastrointestinal Ultrasound ◽  
Inflammatory Bowel ◽  
Wireless Capsule

Abstract Background and Aims Inflammatory bowel disease (IBD) is a lifelong disease requiring frequent assessment to guide treatment and prevent flares or progression. Multiple tools are available for clinicians to monitor disease activity; however, there are a paucity of data to inform which monitoring tools are most acceptable to patients. The review aims to describe the available evidence for patient preference, satisfaction, tolerance and/or acceptability of the available monitoring tools in adults with IBD. Methods Embase, Medline, Cochrane Central and Clinical Trials.gov were searched from January 1980 to April 2019 for all study types reporting on the perspectives of adults with confirmed IBD on monitoring tools, where two or more tools were compared. Outcome measures with summary and descriptive data were presented. Results In 10 studies evaluating 1846 participants, monitoring tools included venipuncture, stool collection, gastrointestinal ultrasound, computed tomography, magnetic resonance imaging, wireless capsule endoscopy, barium follow-through and endoscopy. Outcome domains were patient satisfaction, acceptability of monitoring tool and patient preference. Noninvasive investigations were preferable to endoscopy in nine studies. When assessed, gastrointestinal ultrasound was consistently associated with greater acceptability and satisfaction compared with endoscopy or other imaging modalities. Conclusions Adults with IBD preferred noninvasive investigations, in particular gastrointestinal ultrasound, as compared to endoscopy for monitoring disease activity. When assessing disease activity, patient perceptions should be considered in the selection of monitoring tools. Further research should address whether adpoting monitoring approaches considered more acceptable to patients results in greater satisfaction, adherence and ultimately more beneficial clinical outcomes.

Su1094 A Systematic Review and Meta-Analysis of Non-Invasive Biomarkers for Assessing Disease Activity in Inflammatory Bowel Disease

2015 ◽  
Vol 148 (4) ◽  
pp. S-406 ◽  
Author(s):  
Mahmoud H. Mosli ◽  
Guangyong Zou ◽  
Sushil Kumar Garg ◽  
Sean Feagan ◽  
John K. MacDonald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Non Invasive ◽  
Inflammatory Bowel

Tu1947 Serum Chitinase 3-like-1 (CHI3L1) and Fecal Calprotectin Levels for Non-Invasive Disease Activity Assessment in IBD Patients During Pregnancy

2016 ◽  
Vol 150 (4) ◽  
pp. S987 ◽  
Author(s):  
Hagai Schweistein ◽  
Tomer Adar ◽  
Shimon Shteingart ◽  
Adi Rave ◽  
Sorina G. Granovsky ◽  
...  
Keyword(s):  
Disease Activity ◽  
Fecal Calprotectin ◽  
Invasive Disease ◽  
Non Invasive ◽  
Activity Assessment ◽  
Disease Activity Assessment

scholarly journals Higher Sedation Requirements Among Inflammatory Bowel Disease Patients Undergoing Colonoscopy for Disease Activity Assessment or Dysplasia Surveillance

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Andrew T Weber ◽  
Nimah Ather ◽  
Vivy Tran ◽  
Jenny Sauk ◽  
Christina Ha
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Conscious Sedation ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Activity Assessment ◽  
Included Patient ◽  
Inflammatory Bowel ◽  
Disease Activity Assessment

Abstract Background and Aims Patients with inflammatory bowel disease (IBD) require colonoscopy for diagnosis, disease activity assessment, and dysplasia surveillance. Few studies have evaluated anesthesia needs of IBD patients during procedures. This study aimed to examine sedation requirements of IBD patients undergoing colonoscopy. Methods A retrospective cohort study of IBD and non-IBD patients presenting for colonoscopy between August 2015 and December 2016 was undertaken. Data collected included patient and procedure focused variables. Sedation was categorized as intravenous conscious sedation (IVCS) or monitored anesthesia care (MAC). Results: A total of 522 consecutive colonoscopies (212 IBD, 310 non-IBD) between August 2015 and December 2016 met criteria for inclusion. In total, 323 cases utilized IVCS (56 IBD, 267 non-IBD) and 196 used MAC (155 IBD, 41 non-IBD). Compared with non-IBD patients (13.2%), more IBD patients (73.1%) required MAC (P < 0.01). For IVCS cases, IBD patients required more midazolam (5.73 mg versus non-IBD 4.31 mg; P <0.01) and opioid (IBD 157.59 µg fentanyl equivalents versus non-IBD 119.41 µg; P < 0.01). Diphenhydramine was more frequently added to IVCS for IBD cases (IBD 25.0% versus non-IBD 1.9%; P < 0.01). For MAC cases, propofol dosage was not significantly different between groups (IBD 355.64 mg versus non-IBD 317.104 mg; P = 0.29). IBD colonoscopies took longer (IBD 22.7 versus non-IBD 17.2 min; P < 0.01) and more patients had recent narcotic use (IBD 21.2% versus non-IBD 9.0%; P < 0.01). Conclusions IBD patients required more IVCS, including greater diphenhydramine use with longer procedure times compared with non-IBD patients. These findings suggest MAC should be considered for IBD procedural sedation.

scholarly journals THU0538 IN PSORIATIC ARTHRITIS PATIENTS CONSIDERED IN REMISSION BY THEIR RHEUMATOLOGIST, CAN DISCORDANCE IN DISEASE ACTIVITY ASSESSMENT BETWEEN PATIENT AND RHEUMATOLOGIST BE EXPLAINED BY RESIDUAL INFLAMMATION AS MEASURED BY ULTRASONOGRAPHIC EXAMINATION?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 508-508
Author(s):  
M. Moly ◽  
C. Lukas ◽  
J. Morel ◽  
B. Combe ◽  
G. Mouterde
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Power Doppler ◽  
Minimal Disease Activity ◽  
Activity Assessment ◽  
Grey Scale ◽  
Minimal Disease ◽  
Disease Activity Assessment

Background:Psoriatic arthritis (PsA) is a heterogeneous disease and its assessment is sometimes difficult. Perception of disease activity by patient and physician is frequently discordant in patients in clinical remission. Ultrasound (US) is an imaging technique, which can detect inflammation in PsA.Objectives:The aim of our study was to assess whether persistence of disease activity evaluated by the patient, considered in remission by his rheumatologist, was associated with inflammation measured by US.Methods:We performed a transversal monocentric study. PsA patients were included if they met the CASPAR criteria and were considered in remission by their rheumatologist. Demographic data, characteristics of the disease and treatments were collected. Discordance was defined by a difference between patient’s and rheumatologist’s global assessment ≥30/100 on a Visual Analogic Scale. An US examination was performed on 50 joints, 28 tendons and 14 entheses by an independent investigator. Synovial or tendon sheath hypertrophy and PD signal were evaluated on a semi-quantitative scale, B Mode and PD signal abnormalities on entheses were searched, according to the EULAR-OMERACT scoring system. US remission was defined by no power Doppler (PD) signal on joints, tendons and entheses and minimal US activity by maximum one PD signal on the same sites. Univariate and multivariate analyses were performed to evaluate factors associated with US abnormalities.Results:Sixty-two PsA patients were included. 40.3% were women, the mean (SD) age was 55 (14) years, 42% were in US remission and 71% in minimal US activity (Table 1), 19.4% had ≥1 PD synovitis and 88.7% had a B mode synovitis, 95.2% had a B mode abnormality on entheses and 51.6% had ≥1 PD signal on entheses. Thirty nine percent had a discordant disease activity assessment with their rheumatologist. In univariate analysis, discordance was not associated with US remission (OR=1.71 (95%CI 0.61-4.83), p=0.224) or US minimal disease activity (OR=0.99 (95%CI 0.32-3.05), p=0.602). In multivariate analysis, US remission was independently associated with female gender (OR=3.94 (95%CI 1.20-12.9), p=0.024) and younger age (OR=0.95 (95%CI 0.91-0.99), p=0.027). Minimal US activity was associated with history of enthesis lesion (OR=11.26 (95%CI 1.34-94.93), p=0.026) and age (OR=0.95 (95%CI 0.90-1), p=0.044).Table 1.Ultrasound characteristics of the 62 PsA patients.N (%)Ultrasound remission26 (41.9)Ultrasound minimal disease activity44 (71)Patients with ≥1 grey scale synovitis55 (88.7)Patients with ≥1 Power Doppler synovitis12 (19.4)Patients with ≥1 grey scale tenosynovitis15 (24.2)Patients with ≥1 Power Doppler tenosynovitis1 (1.6)Patients with ≥1 grey scale enthesitis lesion (thickness, hypo echogenicity, calcification, enthesophyte, erosion, bursitis)59 (95.2)Patients with ≥1 Power Doppler enthesitis32 (51.6)Conclusion:Our study showed persistent inflammation evaluated by US in PsA patients considered in remission by their rheumatologist. However, prevalence of residual inflammation evaluated by US was not higher in patients with self-assessment of their disease discordant from their rheumatologist.Disclosure of Interests:Marie Moly: None declared, Cédric Lukas: None declared, Jacques Morel: None declared, Bernard Combe Grant/research support from: Novartis, Pfizer, Roche-Chugai, Consultant of: AbbVie; Gilead Sciences, Inc.; Janssen; Eli Lilly and Company; Pfizer; Roche-Chugai; Sanofi, Speakers bureau: Bristol-Myers Squibb; Gilead Sciences, Inc.; Eli Lilly and Company; Merck Sharp & Dohme; Pfizer; Roche-Chugai; UCB, Gael Mouterde: None declared

Intraepithelial Autoimmune Bullous Dermatoses Disease Activity Assessment and Therapy

2021 ◽  
Author(s):  
Carmen M. Montagnon ◽  
Julia S. Lehman ◽  
Dedee F. Murrell ◽  
Michael J. Camilleri ◽  
Stanislav N. Tolkachjov
Keyword(s):  
Disease Activity ◽  
Activity Assessment ◽  
Disease Activity Assessment
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