Distance management of inflammatory bowel disease: Systematic review and meta-analysis

Table 1 Summary of included studies on distance management of inflammatory bowel disease in adults

Author, yr	Patients randomized/baseline (N) intervention vs control	DiseaseDisease severity	Inclusion/exclusion	Mean age (yr) Control vs intervention	Male (%) Control vs intervention	Intervention	Control	Duration (mo)
Cross et al[26],2012	47 pts rand.14 web vs 18 BAC	UC	Not specified	40.3 vs 41.7	32 vs 40	UC HAT (Home telemanagement: - a home unit (laptop and electronic weight scale) a decision support server, -a web-based clinician portal	Best Available Care (educational material, action plan, clinics visits)	12
Elkjaer et al[27],2010	233 pts rand.105 web vs 106 control	UC mild/mod	Inclusion: age 18-69 yr, mild/moderate UC, treated with 5- ASAExclusion: acute phase of co-morbid conditions, drug dependence or substance abuse, use of immunomodulators, frequent treatment with high dose systemic corticosteroids, likely requirement of IBD surgery, previous IBD surgery	40 vs 44 (P = 0.03)	49.5 vs 31.1(P = 0.008)	Web-intervention (Educational training then http://http://www.constant-care.dk)	Conventional treatment and follow up in the IBD out-patient clinic	12
Elkjaer et al[27], 2010	100 pts rand.51 web vs 41 control	UC	Same as above	41 vs 46	60.8 vs 41.5	Web-intervention (Educational training then http://http://www.constant-care.dk)	Conventional treatment and follow up in the IBD out-patient clinic	12
Kennedy et al[28], 2004Richardson et al[29],2006	700 pts rand.270 interv.365 control	Mild/modCD (n = 231)UC or ID (n = 404)	Inclusion: UC or CD, over age of 16 yr, able to write English, attending a follow-up clinicExclusion: Not specified	46.3 vs 44.4	43 vs 41.5	Guided self-management- patient guidebook- self-management plan- patient centered approach to care by a trained clinician- direct access to services for patients to self-refer	Management process deemed appropriate by the hospital specialist-6 sites follow long term- 2 sites discharge quiescent IBD-1 site no consistent follow up	12
Robinson et al[30],2001	203 pts101 interv.102 control	UC	Inclusion: newly diagnosedExclusion: require hospital outpatient follow-up for other illnesses, unable to read informed consent or follow written instructions	48 vs 49	48 vs 49	Personalised guided self-management regimen with direct access to outpatient care on request	Clinician’s normal treatment and follow-up	Until 11 mo after last pt recruited
Williams et al[88], 2000	180 pts 88 interv.92 control	CD (n = 78) UC or ID (n = 77)Proctitis (n = 25)Inactive or mildly active	Inclusion: over 18 yr, inactive or mildly active but stable IBDExclusion: active disease requiring treatment, stoma, other disease requiring regular follow up, unable to comply with data collection	N/A (no significant difference reported)	N/A (no significant difference reported)	Open access follow up	Routine follow up	24

IBDQ: Inflammatory bowel disease questionnaire; SIBDQ: Short-IBDQ; NS: Not significant; ID: Indeterminate colitis; CD: Crohn’s disease; UC: Ulcerative colitis.