TY - JOUR
T1 - E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial
AU - Vriezinga, Sabine
AU - Borghorst, Annelise
AU - van den Akker-van Marle, Elske
AU - Benninga, Marc
AU - George, Elvira
AU - Hendriks, Danielle
AU - Hopman, Erica
AU - de Meij, Tim
AU - van der Meulen-de Jong, Andrea
AU - Putter, Hein
AU - Rings, Edmond
AU - Schaart, Maaike
AU - Schweizer, Joachim
AU - Smit, Margot
AU - Tabbers, Merit
AU - Weijerman, Michel
AU - Wessels, Margreet
AU - Mearin, M. Luisa
PY - 2018
Y1 - 2018
N2 - Objective: To evaluate the (cost-)effectiveness of online consultations in follow-up of patients with celiac disease (CD). Study design: Multicenter randomized, controlled trial involving 304 patients aged ≤25 years with CD for ≥1 year, randomized to an online (n = 156) or outpatient consultation (n = 148). An online consultation included questionnaires for symptom and growth measurement. Antitransglutaminase-type-2 antibodies were determined using a point-of-care (POC) test. Controls had a traditional consultation with antitransglutaminase-type-2 antibodies testing in laboratories. Both groups completed questionnaires concerning CD-specific health-related quality of life (HRQOL), gluten-free diet adherence, and patient satisfaction. Six months later, participants repeated HRQOL and patient satisfaction questionnaires and the POC test. The primary outcome was anti-transglutaminase-type-2 antibodies after 6 months, and the secondary outcomes were health problems, dietary adherence, HRQOL, patient satisfaction, and costs. Results: The performance of the POC test was inferior to laboratory testing (2/156 positive POC tests vs 13/148 positive laboratory tests; P =.003). Health problems were detected significantly more frequently using online consultation. The detection of growth problems and dietary transgressions was similar. HRQOL (from 1 [good] to 5 [poor]) improved after online consultation (from 3.25 to 3.16 [P =.013] vs controls from 3.10 to 3.23; P =.810). Patient satisfaction (from 1 [low] to 10 [high]) was 7.6 (online) vs 8.0 (controls; P =.001); 58% wished to continue online consultations. Mean costs per participant during the studied period were €202 less for the online group (P <.001). Conclusions: The primary outcome could not be tested because the POC test was unreliable. Nevertheless, our results indicate that online consultations for children and young adults with CD are cost saving, increase CD-specific HRQOL, and are satisfactory for the majority. Trial Registration: Trialregister.nl: NTR3688.
AB - Objective: To evaluate the (cost-)effectiveness of online consultations in follow-up of patients with celiac disease (CD). Study design: Multicenter randomized, controlled trial involving 304 patients aged ≤25 years with CD for ≥1 year, randomized to an online (n = 156) or outpatient consultation (n = 148). An online consultation included questionnaires for symptom and growth measurement. Antitransglutaminase-type-2 antibodies were determined using a point-of-care (POC) test. Controls had a traditional consultation with antitransglutaminase-type-2 antibodies testing in laboratories. Both groups completed questionnaires concerning CD-specific health-related quality of life (HRQOL), gluten-free diet adherence, and patient satisfaction. Six months later, participants repeated HRQOL and patient satisfaction questionnaires and the POC test. The primary outcome was anti-transglutaminase-type-2 antibodies after 6 months, and the secondary outcomes were health problems, dietary adherence, HRQOL, patient satisfaction, and costs. Results: The performance of the POC test was inferior to laboratory testing (2/156 positive POC tests vs 13/148 positive laboratory tests; P =.003). Health problems were detected significantly more frequently using online consultation. The detection of growth problems and dietary transgressions was similar. HRQOL (from 1 [good] to 5 [poor]) improved after online consultation (from 3.25 to 3.16 [P =.013] vs controls from 3.10 to 3.23; P =.810). Patient satisfaction (from 1 [low] to 10 [high]) was 7.6 (online) vs 8.0 (controls; P =.001); 58% wished to continue online consultations. Mean costs per participant during the studied period were €202 less for the online group (P <.001). Conclusions: The primary outcome could not be tested because the POC test was unreliable. Nevertheless, our results indicate that online consultations for children and young adults with CD are cost saving, increase CD-specific HRQOL, and are satisfactory for the majority. Trial Registration: Trialregister.nl: NTR3688.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85038848049&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29275927
U2 - https://doi.org/10.1016/j.jpeds.2017.10.027
DO - https://doi.org/10.1016/j.jpeds.2017.10.027
M3 - Article
C2 - 29275927
SN - 0022-3476
VL - 195
SP - 154-160.e7
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - April
ER -