Delphi method to determine a list of questionnaire-assessed parameters in the follow-up of patients with inflammatory bowel disease.

Abstract

Background. Patients with inflammatory bowel disease (IBD) often require lifelong follow-up by a clinician. A promising area of such health care services is telemedicine monitoring, often based on the evaluation of patients' remote questionnaire results by a medical practitioner. Aim. To define, using the Delphi method, a list of questionnaire-assessed parameters for use in the monitoring and treatment of patients with IBD. Materials and Methods. The study was conducted in three stages. We created an electronic survey form to collect information, making sure that the respondent's experience was included when completing the survey. At the first stage, respondents answered an open-ended question about what parameters assessed by questionnaires should be monitored in patients with IBD. In the second stage, participants answered the same question, but selected any number of items from a list. In the third stage, we analyzed the responses. The primary endpoint was a consensus on each parameter, defined as 75% respondent agreement. Results. There were 15 participants in the study, 13.3% of whom were male. 46% of respondents worked in an outpatient setting and 54% worked in an inpatient setting. The age range was from 25 to 53 years, with 53% of participants having 1 to 4 years of experience and 47% having 17 to 29 years of experience. None of the parameters reached a 75% agreement level based on the results of the first stage. At the second stage, respondents reached consensus on 72% of the parameters. We found no relationship between respondents' age, gender, years of experience, or job setting and responses in both the first and second stages. Conclusions. The final list of parameters recommended for evaluation during monitoring and treatment of patients with IBD included: abdominal pain; frequency of defecation and stool quality; presence of pathological stool impurities; body temperature; joint/muscle pain; sleep quality; anxiety; depression; work capacity for employed/ability of attendance for students; energy, quantity of vigor; fixation on the disease; patients' general evaluation of their life quality; adherence to treatment.