title: Self-managed eHealth Disease Monitoring in Children and Adolescents with Inflammatory Bowel Disease: A Randomized Controlled Trial.
abstract: To evaluate the impact of eHealth on disease activity, the need for hospital contacts, and medical adherence in children and adolescents with inflammatory bowel disease (IBD). Furthermore, to assess eHealth's influence on school attendance and quality of life (QoL).
  
  
  
  Patients with IBD, 10 to 17 years attending a public university hospital, were prospectively randomized to a 2-year open label case-controlled eHealth intervention. The eHealth-group used the web-application young.constant-care.com (YCC) on a monthly basis and in case of flare-ups, and were seen at one annual preplanned outpatient visit. The control-group continued standard visits every third month. Every 3 months, both groups had blood and fecal calprotectin tested and the following were assessed: escalation in medication, disease activity, hospital contacts, medical adherence, school absence, and QoL.
  
  
  
  Fifty-three patients in nonbiological treatment were included (27 eHealth/26 control). We found no differences between the groups regarding escalation in treatment and disease activity (symptoms, fecal calprotectin, and blood). The number of total outpatient visits (mean: eHealth 3.26, SEM 0.51; control 7.31, SEM 0.69; P < 0.0001) and IBD-related school absence (mean days: eHealth 1.6, SEM 0.5; control 16.5, SEM 4.4; P < 0.002) was significantly lower in the eHealth-group. No differences in medical adherence and QoL were found. Adherence to YCC was 81% (384 of the 475 expected entries). None of the patients or parents felt unsafe using the eHealth system.
  
  
  
  The use of eHealth in children and adolescents with IBD is feasible, does not lead to impaired disease control, and can be managed by the patients without risk of increased disease activity.
authors.affiliation: *Department of Pediatrics, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark; †Department of Auto-immunology and Biomarkers, Statens Serum Institute, Copenhagen, Denmark; ‡Clinical Research Centre, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark; §Department of Orthopaedic Surgery, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark; ‖Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark; and ¶Danish Centre for eHealth & Epidemiology, Department of Gastroenterology, North Zealand Hospital, University of Copenhagen, Frederikssund, Denmark.
authors.forename: Katrine
authors.initials: K
authors.lastname: Carlsen
authors.forename: Christian
authors.initials: C
authors.lastname: Jakobsen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Houen
authors.forename: Thomas
authors.initials: T
authors.lastname: Kallemose
authors.forename: Anders
authors.initials: A
authors.lastname: Paerregaard
authors.forename: Lene B
authors.initials: LB
authors.lastname: Riis
authors.forename: Pia
authors.initials: P
authors.lastname: Munkholm
authors.forename: Vibeke
authors.initials: V
authors.lastname: Wewer
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002648:Child; D005240:Feasibility Studies; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012574:Schools / Q000706:statistics & numerical data; D000073278:Self-Management / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D016903:Drug Monitoring
chemical_list: D039841:Leukocyte L1 Antigen Complex