Development of a Web-based concept for patients with ulcerative colitis and 5-aminosalicylic acid treatment.
BACKGROUND
Ulcerative colitis (UC) is a lifelong disease with increasing incidence. UC requires frequent outpatient clinic visits and continuous medical treatment. Web-based self-management in other chronic diseases influences disease course, and increases self-adherence, compliance and quality of life (QoL). Lack of easy access to inflammatory bowel disease clinics and patient education, their understanding of the importance of early treatment at relapse, poor compliance and self-adherence can be partly solved by a newly developed Web-based concept.


OBJECTIVE
To describe the development and validation of the Web-based 'Constant-Care' concept.


METHODS
A Web-based treatment program (www.constant-care.dk) and a Patient Educational Centre for UC patients were developed. The feasibility and acceptance of the concept was validated before (group A) and 6 months after (group B) the start of a randomized controlled trial. Patients' level of disease-specific knowledge, QoL, anxiety and depression were evaluated.


RESULTS
Ten (group A) and 11 (group B) patients fulfilling the diagnostic criteria of mild-to-moderate UC participated in the study. All patients reported an ability to initiate self-treatment after the educational training (ET). A significant increase in knowledge from 36 to 69% (group A) and 28 to 75% (group B) was obtained. A majority of the patients were satisfied with the ET. Patients' QoL, anxiety, depression and general well-being showed no difference after the ET.


CONCLUSIONS
Patient education and training through a Web-based program (www.constant-care.dk) seems to be a feasible concept for increasing patients' ability to self-initiate treatment and increase the level of disease-specific knowledge. Relevant adjustment of the concept was implemented. The final outcome of the 'Constant-Care' concept is pending.
Elkjaer
Margarita
M
Digestive Disease Center, Medical Section, Herlev University Hospital, Herlev Ringvej 75, Herlev 2730, Copenhagen, Denmark. margarita@indutek.com
Burisch
Johan
J
Avnstrøm
Søren
S
Lynge
Elsebeth
E
Munkholm
Pia
P
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000523:psychology; D003194:Computer-Assisted Instruction / Q000379:methods*; D003718:Denmark; D003863:Depression / Q000175:diagnosis; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine