Is home monitoring of inflammatory bowel disease feasible? A randomized controlled study

Abstract

Objectives: The aim of this prospective study was to evaluate the home monitoring with a rapid fecal calprotectin test combined with a symptom questionnaire in patients with colonic IBD in real-life setting.

Methods: We randomized 180 patients with colonic IBD in a study or a control group. The home monitoring patients performed the fecal calprotectin test and filled in a symptom questionnaire every second month and in cases with increasing symptoms. The control patients filled in the symptom questionnaire at baseline and at 6 and 12 months as well as for the appointment at the outpatient clinic. The study duration was 12 months.

Results: The patient adherence to the self-monitoring program was low. Patients with a higher disease burden were more adherent than patients with better health-related quality of life, but otherwise, there were no significant factors predicting the adherence. The home monitoring patients had fewer contacts with the outpatient clinic, but otherwise, the disease course between the home monitoring and the control group were similar.

Conclusions: The self-monitoring of IBD activity with a combination of a rapid fecal calprotectin home test and a symptom questionnaire provides an option for individualized care for IBD patients. However, adherence to the self-monitoring program remains a challenge.

KEYWORDS:

• Crohn´s disease
• fecal calprotectin
• disease activity
• ulcerative colitis

Acknowledgments

The authors thank their study nurses Pirkko Tuukkala, Virpi Pelkonen and Sari Karesvuori for their assistance.

Author contributions

A.-M.P. designed the study, performed the statistical analysis, and drafted and completed the manuscript. K.-L.K. participated in designing and supervision of the study and helped to draft the manuscript. H.A. performed and analyzed the rapid fecal tests and helped to draft the manuscript. M.F. designed and supervised the study and helped in drafting the manuscript. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grant from the Helsinki University Hospital Research Fund [TYH2015405].