New approach to management of ulcerative colitis

September 20, 2001

N.B. Please note that if you are outside North America the embargo for Lancet Press material is 0001 hours UK Time friday September 21st 2001.

Self-management of patients with ulcerative colitis could reduce health-care costs without compromising disease treatment, conclude authors of a study in this week's issue of THE LANCET.

Ulcerative colitis 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, UK, did a randomised controlled trial to assess an alternative to traditional outpatient care.

203 patients with ulcerative colitis (who were undergoing hospital follow-up) were randomly assigned to receive either patient-centred 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 per patient per year). Health-related quality-of-life scores were similar (indicating mild to moderate symptoms) in both groups at the beginning and end of the trial.
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Andrew 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."

Contact: Dr Andrew Robinson, Section of Gastrointestinal Science, University of Manchester, Clinical Sciences Building, Hope Hospital, Stott Lane, Salford, M6 8HD,UK;T) 44-161-0161-787-4363/1510;F) 44-161-787-1495;E) arobinso@fs1.ho.man.ac.uk

Lancet

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