Ulcerative colitis (UC) affects around 100,000 people a year in the UK.
Relapse is common, and is usually managed by medical treatment in secondary care by regular outpatient reviews.
Andrew Robinson and colleagues from the University of Manchester, England, conducted a randomized controlled trial to assess an alternative to traditional outpatient care.
Some 203 patients with UC (who were undergoing hospital follow-up) were randomly assigned to receive patient-centered self-management training and follow-up on request, or conventional outpatient treatment and follow-up.
Patients assigned self-management had relapses treated more quickly than those given conventional treatment (15 hours compared with 50 hours).
Self-management patients made fewer visits to hospital (0.9 compared with 2.9 per patient per year), and to the primary-care physician (0.3 compared with 0.9).
|Benefits of self-management in UC patients:|
- Relapses treated more quickly
- Fewer hospital visits
- Fewer visits to primary-care physicians
Health-related quality-of-life scores were similar (indicating mild to moderate symptoms) in both groups at the beginning and end of the trial.
Dr Robinson comments, "Self-management of ulcerative colitis accelerates treatment provision and reduces doctor visits, and does not increase morbidity.
"This approach could be used in long-term management of many other chronic diseases to improve health-service provision and use, and to reduce costs."