Comparative Acceptability and Perceived Clinical Utility of Monitoring Tools: A Nationwide Survey of Patients with Inflammatory Bowel Disease
Comparative Acceptability and Perceived Clinical Utility of Monitoring Tools: A Nationwide Survey of Patients with Inflammatory Bowel Disease
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DOI：
10.1097/mib.0000000000001140
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发表时间：
2017-08-01
影响因子：
4.9
通讯作者：
Bouguen, Guillaume
中科院分区：
文献类型：
--
作者：
Buisson, Anthony;Gonzalez, Florent;Bouguen, Guillaume
背景：炎症性肠病（IBD）期间肠道炎症的客观控制正成为药物治疗的主要驱动力。然而，对与监测工具有关的负担的调查仍然很差。我们的目的是评估他们的比较接受性和实用性，根据IBD患者。方法：经过初步阶段，最终的问卷调查，包括自我管理和医生问卷前瞻性和连续提交给916例IBD患者从20个公共和私人中心。可接受性和实用性视觉模拟量表（VAS）表示为中位数和四分位数间距。结果：对于克罗恩病患者组（n = 618），静脉穿刺（VAS = 9.3 [8.8-9.7]）和超声检查（VAS = 9.3 [8.7-9.7]）是最可接受的工具（P < 0.0001，每次比较），而直肠乙状结肠镜检查是最不可接受的工具（VAS = 4.4 [1.2-7.3]）（P < 0.0001，每次比较）。无线胶囊式内窥镜检查（VAS = 8.5 [5.2-9.3]）、磁共振小肠结肠成像（VAS = 8.0 [5.0-9.2]）和粪便收集（VAS = 7.7 [4.6-9.3]）比结肠镜检查（VAS = 6.7 [4.3-8.9]）更容易接受（P < 0.0001，每次比较）。在298例溃疡性结肠炎患者中评估了静脉穿刺（VAS = 9.4 [8.8-9.7]）、粪便收集（VAS = 8.1 [5.7-9.4]）、结肠镜检查（VAS = 7.5 [4.7-9.2]）和直肠乙状结肠镜检查（VAS = 6.7 [2.8-9.1]）的可接受性;（每次比较P < 0.001）。IBD患者认为所有监测工具都非常有用。可接受性降低与粪便收集/运输的尴尬有关（60.7%），肠道清洁（76.3%）用于结肠镜检查，腹部不适（51.3%）和直肠灌肠（36.6%）用于直肠乙状结肠镜检查，肠扩张（48.3%）用于磁共振肠结肠成像，以及潜在的胶囊滞留结论：在IBD监测工具中，内窥镜检查的可接受性最低，支持替代模式的发展。应改善患者信息和检查条件，以确保适当的监测依从性。
Background: Objective control of intestinal inflammation during inflammatory bowel disease (IBD) is becoming the main driver for medical treatment. However, the monitoring tools-related burden remains poorly investigated. We aimed to evaluate their comparative acceptability and utility according to patients with IBD.Methods: After a preliminary phase, the final questionnaire encompassing self-administered and physician questionnaires was prospectively and consecutively submitted to 916 patients with IBD from 20 public and private centers. Acceptability and utility visual analog scales (VAS) were expressed as median with interquartile range.Results: Regarding the group of patients with Crohn's disease (n = 618), venipuncture (VAS = 9.3 [8.8-9.7]) and ultrasonography (VAS = 9.3 [8.7-9.7]) were the most acceptable tools (P < 0.0001, for each comparison), whereas rectosigmoidoscopy was the least acceptable tool (VAS = 4.4 [1.2-7.3]) (P < 0.0001, for each comparison). Wireless capsule endoscopy (VAS = 8.5 [5.2-9.3]), magnetic resonance enterocolonography (VAS = 8.0 [5.0-9.2]), and stools collection (VAS = 7.7 [4.6-9.3]) were more acceptable than colonoscopy (VAS = 6.7 [4.3-8.9]) (P < 0.0001, for each comparison). The acceptability was assessed in 298 patients with ulcerative colitis for venipuncture (VAS = 9.4 [8.8-9.7]), stools collection (VAS = 8.1 [5.7-9.4]), colonoscopy (VAS = 7.5 [4.7-9.2]), and rectosigmoidoscopy (VAS = 6.7 [2.8-9.1]); (P < 0.001 for each comparison). All monitoring tools were considered as highly useful by patients with IBD. Decreased acceptability was related to embarrassment for the collection/transport of stools (60.7%), bowel cleansing (76.3%) for colonoscopy, abdominal discomfort (51.3%) and rectal enema (36.6%) for rectosigmoidoscopy, bowel distension (48.3%) for magnetic resonance enterocolonography, and potential capsule retention (21.4%) for wireless capsule endoscopy.Conclusions: Among the IBD monitoring tools, endoscopy demonstrated the lowest acceptability supporting the development of alternative modalities. Patients' information and examination conditions should be improved to ensure proper monitoring adherence.