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Digestive Diseases and Sciences

, Volume 63, Issue 9, pp 2220–2230 | Cite as

Disease Activity Patterns Recorded Using a Mobile Monitoring System Are Associated with Clinical Outcomes of Patients with Crohn’s Disease

  • Eun Soo Kim
  • Sung Kook Kim
  • Byung Ik JangEmail author
  • Kyeong Ok Kim
  • Eun Young Kim
  • Yoo Jin Lee
  • Hyun Seok Lee
  • Sang Gyu Kwak
  • the Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)
Original Article

Abstract

Background

Usefulness of a mobile monitoring system for Crohn’s disease (CD) has not been evaluated. We aimed to determine whether disease activity patterns depicted using a web-based symptom diary for CD could indicate disease clinical outcomes.

Methods

Patients with CD from tertiary hospitals were prospectively invited to record their symptoms using a smartphone at least once a week. Disease activity patterns for at least 2 months were statistically classified into good and poor groups based on two factors in two consecutive time frames; the degree of score variation (maximum–minimum) in each frame and the trend (upward, stationary, or downward) of patterns indicated by the difference in the mean activity scores between two time frames.

Results

Overall, 220 (82.7%) and 46 (17.3%) patients were included in good and poor groups, respectively. Poor group was significantly more associated with disease-related hospitalization (p = 0.004), unscheduled hospital visits (p = 0.005), and bowel surgery (p < 0.001) during the follow-up period than good group. In the multivariate analysis, poor patterns [odds ratio (OR) 2.62, p = 0.006], stricturing (OR 4.19, p < 0.001) or penetrating behavior (OR 2.27, p = 0.012), and young age at diagnosis (OR 1.06, p = 0.019) were independently associated with disease-related hospitalization. Poor patterns (OR 4.06, p = 0.006) and an ileal location (OR 5.79, p = 0.032) remained independent risk factors for unscheduled visits. Poor patterns (OR 15.2, p < 0.001) and stricturing behavior (OR 9.77, p = 0.004) were independent risk factors for bowel surgery.

Conclusion

The disease activity patterns depicted using a web-based symptom diary were useful indicators of poor clinical outcomes in patients with CD.

Keywords

Crohn’s disease Disease activity pattern Smartphone 

Notes

Funding

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2015R1D1A1A02062168) and by the research promoting grant from the Keimyung University Dongsan Medical Center in 2011.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflicts of interest.

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Eun Soo Kim
    • 1
    • 4
  • Sung Kook Kim
    • 1
  • Byung Ik Jang
    • 2
    Email author
  • Kyeong Ok Kim
    • 2
  • Eun Young Kim
    • 3
  • Yoo Jin Lee
    • 4
  • Hyun Seok Lee
    • 1
  • Sang Gyu Kwak
    • 5
  • the Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)
  1. 1.Division of Gastroenterology, Department of Internal Medicine, School of MedicineKyungpook National UniversityDaeguKorea
  2. 2.Division of Gastroenterology and Hepatology, Department of Internal MedicineYeungnam University College of MedicineDaeguKorea
  3. 3.Division of Gastroenterology, Department of Internal MedicineCatholic University of Daegu School of MedicineDaeguKorea
  4. 4.Division of Gastroenterology, Department of Internal MedicineKeimyung University School of MedicineDaeguKorea
  5. 5.Department of Medical StatisticsCatholic University of Daegu School of MedicineDaeguKorea

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