The Care of Children and Adolescents with Chronic Inflammatory Bowel Disease: A Cluster-Randomized Trial on Improving the Guideline Conformity of Treatment by the Use of the CEDATA-GPGE Patient Registry.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Luisa Tischler, Aletta Boerkoel, Heiko Krause, Neeltje van den Berg, Jan de Laffolie
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引用次数: 0

Abstract

Background: For children and adolescents with chronic inflammatory bowel disease (IBD), treatment that is not in adequate conformity with the guidelines can adversely affect both the course of disease and the patients' development. The targeted use of digital patient registries may improve real-life adherence to the recommendations of evidence-based guidelines.

Methods: In a cluster-randomized, controlled trial (DRKS00015505), treatment providers for the intervention group (IG) documented the treatment of children and adolescents with IBD in the CEDATA-GPGE patient registry; they received automated feedback on the data they entered and on potential deviations of the documented treatment from recommendations contained in the guidelines (care deficits). Treatments providers for the control group (CG) documented treatments as previously, i.e., only in the patients' charts. At the end of a twelve-month observation period, the data from both groups at baseline and on follow-up were analyzed in an intergroup comparison. The primary endpoint was the number of care deficits at twelve months.

Results: 319 patients were recruited from 47 pediatric gas troen tero logical centers in Germany (IG: 21 centers and 160 subjects; CG: 26 centers and 159 subjects). Among the 146 subjects in the IG who were followed up at 12 months, there were an average (mean) of 0.17 care deficits per patient (95% confidence interval [0.10; 0.24]). Among the 134 subjects in the CG who were followed up at 12 months, there were an average (mean) of 0.55 [0.43; 0.66] identified care deficits per patient (p < 0.0001).

Conclusion: Registry-based feedback can help bring treatment and its documentation into better con for - mity with the relevant guidelines and thereby reduce or prevent care deficits in children and adolescents with IBD.

儿童和青少年慢性炎症性肠病患者的护理:利用 CEDATA-GPGE 患者登记册改善治疗指南一致性的分组随机试验》。
背景:对于患有慢性炎症性肠病(IBD)的儿童和青少年来说,如果治疗不完全符合指南的要求,就会对病程和患者的发展产生不利影响。有针对性地使用数字患者登记册可改善现实生活中对循证指南建议的遵守情况:在一项分组随机对照试验(DRKS00015505)中,干预组(IG)的治疗提供者在 CEDATA-GPGE 患者登记册中记录了对患有 IBD 的儿童和青少年的治疗情况;他们会收到关于所输入数据的自动反馈,以及关于所记录治疗与指南中建议的潜在偏差(护理缺陷)的自动反馈。对照组(CG)的治疗提供者则像以前一样记录治疗,即只在患者病历中记录。在为期 12 个月的观察期结束时,对两组基线数据和随访数据进行组间比较分析。主要终点是十二个月时护理缺陷的数量:德国 47 家儿科胃肠病中心共招募了 319 名患者(IG:21 家中心,160 名受试者;CG:26 家中心,159 名受试者)。在随访 12 个月的 146 名 IG 受试者中,平均每名患者的护理缺陷为 0.17(平均值)(95% 置信区间 [0.10; 0.24])。在随访12个月的134名CG受试者中,每名患者平均(平均)发现0.55 [0.43; 0.66]个护理缺陷(P < 0.0001):以登记为基础的反馈有助于使治疗及其记录更加符合相关指南,从而减少或预防儿童和青少年 IBD 患者的护理缺陷。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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