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Support Tool Helps Standardize Ulcerative Colitis Care
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Patients who used a tablet-based decision support tool during their ulcerative colitis treatment experienced improved delivery of care, according to study results published in Alimentary Pharmacology & Therapeutics.
Peter De Cruz, MBBS, PhD, FRACP, of the Austin Academic Centre at the University of Melbourne in Australia, and colleagues wrote that managing patient care in inflammatory bowel disease is difficult because the complexities of treatment are prone to human error, and variation in care remains an important barrier to quality IBD treatment.
“Standardizing practice via clinical pathways using participatory care models may be one way to maintain quality of care,” they wrote. “Participatory health care models involve a collaboration between patient and physician and refers to a movement in which networked patients move from being merely passengers to responsible drivers of their health care. Participatory medicine promotes shared decisionmaking and facilitates patients’ selfmanagement of their disease.”
Researchers conducted a prospective quality of care intervention at two Australian hospitals to compare outpatient UC care with and without the tablet-based decision support tool. The tool utilized questions focused on disease activity management, psychological well-being and preventive care. Each factor included 13 process indicators that help indicate quality of care.
Investigators separated 100 patients with mild to moderate UC in two groups. Those in the first group used the support tool immediately before their consultation to generate a suggested management plan for them to discuss with their physician. In the second group, researchers immediately followed patients to determine whether their physicians had discussed the 13 process indicators during their consultation.
During the 20-week study, De Cruz and colleagues observed an increase in the median use of process indicators after use of the decision tool (27% vs. 100%; P < .001). They also noted improvements in psychological well-being management (30% vs. 100%; P < .001), preventive care (16% vs. 100%; P < .001) and process indicators related to disease activity management (50% vs. 100%; P < .001).
De Cruz and colleagues wrote that decision support tools have the potential to keep variation in care to a minimum by enabling a standardized approach and keeping patients engaged.
“Decision support tools facilitate participatory care by promoting shared decisionmaking and increasing patient engagement in their management,” they wrote. “Longitudinal populationbased studies are now required to evaluate the extent to which quality improvements are sustained and identify which patients and clinicians are most likely to benefit from using the decision support tool in clinical practice. The potential value of the decision support tool in facilitating selfmanagement as part of a remote monitoring strategy together with its costbenefit also warrants further investigation.” – by Alex Young
Disclosures: De Cruz reports he receives educational grants and is a speaker at education symposia sponsored by AbbVie, Baxter, Ferring, Janssen, Shire and Takeda. He also reports being on the advisory boards for Baxter, Celgene, Ferring, Janssen, Shire and Takeda. Please see the study for all other authors’ relevant financial disclosures.
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