eHealth: individualisation of infliximab treatment and disease course via a self‐managed web‐based solution in Crohn's disease

Abstract

SUMMARY BackgroundInfliximab (IFX) maintenance therapy for Crohn's disease (CD) is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist.

Development of a Web-based, self-reporting symptom diary for Crohn's Disease, and its correlation with the Crohn's Disease Activity Index

“…Recognizing the shortcomings of CDAI (such as impracticability and the inherent deviations arising from recall bias in data collection), and the importance of disease monitoring in CD, several published studies have used a self-reporting symptom collecting tool, using an electronic diary or web-based system to assess symptoms in patients with CD [15,17]. The study by Litcher-Kelly et al reported the feasibility of an electronic diary for collecting symptoms using software installed on a handheld computer [17].…”

“…However, they did not establish detailed parameters for the diary, and the sample size was very small (n = 16). Recently, a web-based telemanagement system has been introduced for patients with IBD, which has encouraged the active involvement of patients in the assessment and treatment of their disease [14,15]. The open-label pilot study reported the efficacy, and safety, of a web-based approach for the maintenance of infliximab treatment for patients with CD, suggesting that this novel method might be a promising concept for the individualization of infliximab treatment in IBD [15].…”

“…Recently, a web-based telemanagement system has been introduced for patients with IBD, which has encouraged the active involvement of patients in the assessment and treatment of their disease [14,15]. The open-label pilot study reported the efficacy, and safety, of a web-based approach for the maintenance of infliximab treatment for patients with CD, suggesting that this novel method might be a promising concept for the individualization of infliximab treatment in IBD [15]. In that study, although patients recorded their disease activity using the HBI, as was the case in our study, they did not validate it compared with disease activity assessed by the CDAI.…”

“…For this reason, telemanagement has been implemented for use in inflammatory bowel disease (IBD) as well as various chronic conditions such as asthma, congestive heart failure, and diabetes-and has resulted in improved disease outcomes [11][12][13][14][15]. Although a selfmanaged, web-based monitoring system for patients with CD was already developed in a recent study, results using the monitoring system were not compared with results using the CDAI (which is the gold standard, and only currently validated system for CD activity)-leading to doubts about its reliability [15].…”

“…Although a selfmanaged, web-based monitoring system for patients with CD was already developed in a recent study, results using the monitoring system were not compared with results using the CDAI (which is the gold standard, and only currently validated system for CD activity)-leading to doubts about its reliability [15].…”