E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial

Sabine Vriezinga, Annelise Borghorst, Elske van den Akker-van Marle, Marc Benninga, Elvira George, Danielle Hendriks, Erica Hopman, Tim de Meij, Andrea van der Meulen-de Jong, Hein Putter, Edmond Rings, Maaike Schaart, Joachim Schweizer, Margot Smit, Merit Tabbers, Michel Weijerman, Margreet Wessels, M. Luisa Mearin

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)154-160.e7
JournalJournal of Pediatrics
Volume195
DOIs
Publication statusPublished - 2018

Cite this

Vriezinga, S., Borghorst, A., van den Akker-van Marle, E., Benninga, M., George, E., Hendriks, D., ... Mearin, M. L. (2018). E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial. Journal of Pediatrics, 195, 154-160.e7. https://doi.org/10.1016/j.jpeds.2017.10.027
Vriezinga, Sabine ; Borghorst, Annelise ; van den Akker-van Marle, Elske ; Benninga, Marc ; George, Elvira ; Hendriks, Danielle ; Hopman, Erica ; de Meij, Tim ; van der Meulen-de Jong, Andrea ; Putter, Hein ; Rings, Edmond ; Schaart, Maaike ; Schweizer, Joachim ; Smit, Margot ; Tabbers, Merit ; Weijerman, Michel ; Wessels, Margreet ; Mearin, M. Luisa. / E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial. In: Journal of Pediatrics. 2018 ; Vol. 195. pp. 154-160.e7.
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abstract = "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.",
author = "Sabine Vriezinga and Annelise Borghorst and {van den Akker-van Marle}, Elske and Marc Benninga and Elvira George and Danielle Hendriks and Erica Hopman and {de Meij}, Tim and {van der Meulen-de Jong}, Andrea and Hein Putter and Edmond Rings and Maaike Schaart and Joachim Schweizer and Margot Smit and Merit Tabbers and Michel Weijerman and Margreet Wessels and Mearin, {M. Luisa}",
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Vriezinga, S, Borghorst, A, van den Akker-van Marle, E, Benninga, M, George, E, Hendriks, D, Hopman, E, de Meij, T, van der Meulen-de Jong, A, Putter, H, Rings, E, Schaart, M, Schweizer, J, Smit, M, Tabbers, M, Weijerman, M, Wessels, M & Mearin, ML 2018, 'E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial' Journal of Pediatrics, vol. 195, pp. 154-160.e7. https://doi.org/10.1016/j.jpeds.2017.10.027

E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial. / Vriezinga, Sabine; Borghorst, Annelise; van den Akker-van Marle, Elske; Benninga, Marc; George, Elvira; Hendriks, Danielle; Hopman, Erica; de Meij, Tim; van der Meulen-de Jong, Andrea; Putter, Hein; Rings, Edmond; Schaart, Maaike; Schweizer, Joachim; Smit, Margot; Tabbers, Merit; Weijerman, Michel; Wessels, Margreet; Mearin, M. Luisa.

In: Journal of Pediatrics, Vol. 195, 2018, p. 154-160.e7.

Research output: Contribution to journalArticleAcademicpeer-review

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.

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Vriezinga S, Borghorst A, van den Akker-van Marle E, Benninga M, George E, Hendriks D et al. E-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial. Journal of Pediatrics. 2018;195:154-160.e7. https://doi.org/10.1016/j.jpeds.2017.10.027