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P374 The clinical usefulness of the web based message system between patients with Crohn’s disease and their physicians

B.I. Jang1, K.O. Kim*1, E.S. Kim2, K.S. Park2, K.B. Cho2, E.Y. Kim3, J.T. Jung3, S.W. Jeon4, H.S. Lee4, C.H. Yang5, Y.K. Lee5

1Yeungnam University College of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu, Korea, Republic of, 2Keimyung University College of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu, Korea, Republic of, 3Catholic University of Daegu School of Medicine, Internal Medicine, Daegu, Korea, Republic of, 4Kyungpook National University Hospital, Gastroenterology, Daegu, Korea, Republic of, 5Dongguk University College of Medicine, Division of gastroenterology and Hepatology, department of Internal Medicine, Kyungju, Korea, Republic of

Background

Crohn’ s disease(CD) is a chronic relapsing disorder of unknown etiology and many CD patients encounter unpredictable events not catched at one single outpatients visit. For not to miss these events associated with clinical activity, we previously developed a novel, web-based, self-reporting CD symptom diary (CDSD) using website. There was also a message system below the score box for helping the many unpredictable events or questions of the patients. The aims of the present study was to assess the clinical usefulness of the system by analyzing the message lists during no visiting period.

Methods

We opened the communication system using message between patients and their doctors at the same web page already made for symptom diary (www.cdsd.or.kr). Patients can send a message easily whenever they need and the doctor can read it and send the answers immediately using their phone or computer. For the real time comunication, we used an alarm when the message was sent. We retrospectively reviewed all the 686 message lists from 152 patients and the medical records of the patients from July 2012 to July 2014. The patients baseline characteristics and clinical feature of the disease were also assessed. The messages were classified into several categories and each catetories were subdivided again into several categories.

Results

The mean age of the 152 CD patients was 29.7 ± 10.7 years and male to female ratio was 99:53. Mean message number per patients was 4.5. The most common problem list was about symptom (381 cases, 55.5%) and questions about their treatment were in 71 cases(10.3%). In cases of symptoms, abdominal pain was most common problem in 145 cases(21.1%) and hematochazia in 36 cases (5.2%). Symptoms other than abdomen were also noted in 73 cases(11.1%). Problems about medication were the most frequent messages associated with treatment in 65 cases (91.5%). Patients under 40 years sent more variable messages, however, patients above 40years, showed the tendency to focus on symptoms and treatment (p=0.025).However, it was not significantly different according to the disease extent and behavior. The answer rate by their doctors was 56.3% and early visiting by their physician’s answer was needed in 28 cases(7.3%).

Conclusion

Patients could get the advice or answers by their physicians in charge directly about their unpredictable problem without visiting clinics or internet searching . In addition, cases needed early visit could be also achieved in 7.3% using the system. Although we need a long term follow up, our Results showed that the message sending system on the websites (www.cdsd.or.kr) could be a useful communication tool for the patients and physicians during non-visinting period.