Real Life Remote Monitoring of Mild, Moderate and Severe Infectious Complications in IBD by Patient Reported Assessment
Condition: Inflammatory Bowel Diseases; Crohn Disease; Ulcerative Colitis; IBD; Digestive System Disease; Patient Reported Outcome Measures
MeSH terms: Crohn Disease; Inflammatory Bowel Diseases; Digestive System Diseases; Gastrointestinal Diseases
Study type: Observational

Summary: 
      Inflammatory bowel disease (IBD) is a chronic relapsing immune mediated inflammatory disease
      (IMID) of the gastrointestinal tract. Like all IMIDs (e.g. rheumatoid arthritis, psoriasis) a
      complex interaction between a genetically altered immune response, the gut microbiota and
      environmental factors is causing the disease. Systemic suppression of the immune response
      with corticosteroids, immunomodulatory, biologicals and combination therapies increases the
      risk of opportunistic infections in IBD patients.

      Data on mild and moderate infections in medically treated IBD patients is scarce, mainly
      since infections treated by the general practitioner or in an outpatient setting are not
      systematically registered in real life. To help gastroenterologists with clinical decision
      making, real world data with long term follow-up concerning the risk for infectious
      complications, is warranted.

      Several observations underline the importance of real world data on mild and moderate
      infections in medically treated IBD patients. Mild and moderate infections mostly have a
      benign course, but they take longer to clear and have a large impact on (work)disability and
      quality of life in IBD patients. Recurrent infections influences peoples willingness to use a
      drug and negatively effects adherence. Furthermore, recurring mild and moderate infections
      might prognosticate serious infections, and systematic assessment of all infections could be
      used to timely adjust treatment regimens and prevent serious infections.

      The investigators of this study previously developed a questionnaire on self-reported
      infections according to the FDA guideline for patient-reported outcome measures (PROM) by
      interviewing 36 patients with IBD and through input of expert meetings with
      gastroenterologists, IBD specialists, rheumatologists, immunologists and IBD-nurses. This
      questionnaire has already been implemented in myIBDcoach, a validated telemedicine system
      implemented in routine care for over 4000 patients with IBD in the Netherlands. Assesment of
      reliability and validity are the last steps in validation of this remote monitoring tool.

      In the current study the investigators aim to:

        1. Assess the reliability, construct validity and criterion validity of a remote monitoring
           tool (questionnaire) for infections as last step in the validation

        2. Assess the relative risk of all infections (mild, moderate and severe) in a real-life
           population for IBD patients on different maintenance treatments

        3. Identify the predictors and risk factors of mild and moderate infections.

        4. Assess the relation between patient reported infections and the risk for serious
           infectious complications
    


Intervention name(s): Remote monitoring tool (infections questionnaire) validation
Intervention type(s): Other
Intervention description(s): There will be no treatment intervention in the current study (no drugs will be used). Instead, patients are enrolled in a routine care eHealth care-pathway with myIBDcoach. MyIBDcoach (MijnIBDcoach, Dutch, Sananet Care B.V., Sittard, The Netherlands, https://www.mijnibdcoach.nl) is a web-based platform for home-monitoring and patient- provider communication in patients with IBD.
Patients already using the myIBDcoach will be informed on this study. Patients will be asked to continue routine care including monitoring of PROs through the myIBDcoach. When a patient completes the infections disease questionnaire for the first time, this will be regarded as the starting point (T=0) for this patient. Patients will complete the questionnaire every three months after the starting point as part of their routine follow-up. Results from these questionnaires will be stored electronically and will be analyzed alongside medical records of GP's and drug delivery data from pharmacies.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adults with medically treated inflammatory bowel disease (IBD) (ulcerative colitis and
        Crohn's disease) included in the eHealth clinical care-pathway using myIBDcoach and
        followed on the outpatient clinic of Maastricht University Medical Centre or Zuyderland
        Medical Centre.