494 Association Between Thiopurines Metabolites Levels and Clinical Remission in IBD Patients: An Updated Meta-Analysis

Abstract

attending a regional meeting were asked to complete the survey. Attitudes were assessed using framework analysis. Responses were coded into categories. Preferences were analysed by quantifying scores for each component and calculating the percentages of clinicians’ who agreed, were neutral or disagreed. Results: 38% (16/42) of attendees completed the questionnaire. The following themes emerged. Four inter-related but distinct advantages were identified. 1. Increased patient participation/ownership. 2. Greater knowledge and understanding. 3. Improved patient-provider communication. 4. Enhanced safety. Potential concerns were categorised into three themes. 1. Interpretation of the data. 2. Extra workload. 3. Inequalities of service. Pre-conditions were organizational and included informed consent, opt-in only, automation of data transfer, security and restriction of selected data. 100% of the respondents agreed a summary of their history and medicines should be included. 94% agreed that a symptommonitoring tool would be useful. 88% and 63% agreed patients should have access to their letters and bloods. The biggest concern identified would be providing imaging and endoscopy reports with only 31% agreeing, 44% neutral and 25% disagreeing. Many felt reports would be misinterpreted and cause anxiety. An online forum and email support divided opinion, with 56% agreeing and 44% neutral or disagreeing to these services. Concerns were raised with moderating email contact and content of the forum. Conclusions: Previous research has shown many e-health technologies fail in routine practice due to lack of stakeholder involvement. Clinicians’ views are critical to successfully implement a web-based service designed to improve the delivery of care. These views have been incorporated into the design of an IBD portal system.