4.6 Article

Patient-reported Outcomes: the ICHOM Standard Set for Inflammatory Bowel Disease in Real-life Practice Helps Quantify Deficits in Current Care

Journal

JOURNAL OF CROHNS & COLITIS
Volume 16, Issue 12, Pages 1874-1881

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/ecco-jcc/jjac099

Keywords

Inflammatory bowel disease; patient reported outcomes; ICHOM

Funding

  1. NIHR Local Clinical Research Network
  2. Department of Health via the NIHR comprehensive Biomedical Research Centre
  3. NIHR Oxford Health BRC
  4. NIHR Oxford Biomedical Research Centre [11/YH/0020, 16/YH/0247]
  5. University of Oxford

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This study reports on the symptoms, quality of life, and ICHOM IBD outcomes of patients with inflammatory bowel disease. The results illustrate the therapeutic deficit in current care, and demonstrate that patient-reported outcome data can be collected continuously with little burden on healthcare professionals.
Background Patient-reported outcome measures [PROMs] are key to documenting outcomes that matter most to patients and are increasingly important to commissioners of health care seeking value. We report the first series of the ICHOM Standard Set for Inflammatory Bowel Disease [IBD]. Methods Patients treated for ulcerative colitis [UC] or Crohn's disease [CD] in our centre were offered enrolment into the web-based TrueColours-IBD programme. Through this programme, e-mail prompts linking to validated questionnaires were sent for symptoms, quality of life, and ICHOM IBD outcomes. Results The first 1299 consecutive patients enrolled [779 UC, 520 CD] were studied with median 270 days of follow-up (interquartile range [IQR] 116, 504). 671 [52%] were female, mean age 42 years (standard deviation [sd] 16), mean body mass index [BMI] 26 [sd 5.3]. At registration, 483 [37%] were using advanced therapies. Median adherence to fortnightly quality of life reporting and quarterly outcomes was 100% [IQR 48, 100%] and 100% [IQR 75, 100%], respectively. In the previous 12 months, prednisolone use was reported by 229 [29%] patients with UC vs 81 [16%] with CD, p 3 months. An IBD-related intervention was reported by 174 [13%] patients, and 80 [6%] reported an unplanned hospital admission. There were high rates of fatigue [50%] and mood disturbance [23%]. Conclusions Outcomes reported by patients illustrate the scale of the therapeutic deficit in current care. Proof of principle is demonstrated that PROM data can be collected continuously with little burden on health care professionals. This may become a metric for quality improvement programmes or to compare outcomes.

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