Which is the easiest and the optimal way

Which is the easiest and the optimal way to follow up our patients? SANDOR LOVASZ MD. PHD. RÓZSAKERT MEDICAL CENTER, BUDAPEST, HUNGARY

Long-term follow-up of IC/BPS patients. In cases of some chronic diseases the long-term follow up is indispensable. Especially in IC/BPS, the continuous observation of the patients’ condition is essential to enable individually tailored maintenance therapy. Conventional way of monitoring needs regular patient-doctor meetings, being Long-term follow up of patients’ condition time-consuming for both the patient and the medical staff (expenses) remains an unsolved task in most cases. Regular data collection for monitoring requires sophisticated logistics. It is hardly impossible to recall the patient’s actual condition. Imagine the scenario: patient enters examination room…

The solution: a home site for long-term follow up of the patients We present our home site dedicated to newly diagnosed IC/BPS patients. www. bladderpain. eu Doctors need to register first to get capable to collect his patients on this site. Patients need to register under their own doctor’s name.

Benefits for the attending doctor All data relating to IC/BPS patients’ condition are stored in one place and can be retrieved and reviewed at any time. Graphic images help doctors in decision-making by providing immediate access to epicrisis, current condition, and trends of changes. The doctor can individually tailor therapy and optimize the schedule of treatments thus minimize both over- and undertreatment. The graphic representation of data provides important information during teleconsultation with the patient. Database of collected data permits of statistical evaluation.

Advantages for the patient The optimized frequency of treatments results in lower expenses and better results in therapy. The patient can stay in worthwhile long-distance contact with the doctor (teleconsultation) The diagrams provide a visual confirmation of the effectiveness of the treatment, which inspires the patient for further cooperation. The compulsion to provide data regularly results in a high-compliance relationship between the patient and the doctor. Even in cases of self-treatment (self-catheterization), follow-up system gives the opportunity to the patient to receive continuous professional guidance and to remain under control of therapist.

Data acquisition Filled in by the patients over the Internet 1. IC/BPS questionnaires Ø Ø O’Leary-Sant -validated Dorfman (PUF) -validated BPIC-SS -validated IC-Pain Lovasz -non validated 2. The 2 -day voiding diary for the GAG-layer integrity test Initial data upload to the web site 1 or 2 times before beginning any treatment During the course of treatment, the patient needs to repeat data acquisition, with a frequency defined by the doctor.

Real time presentation of the collected data The therapist and patient have access to the course of the measured parameters presented in charts, visualizing patient’s current condition. The feedback of the graphs makes the patients’ condition more transparent and let slow changes and tendencies become evident, letting therapist adjust the treatment protocol accordingly.

A few samples of data charts From the Hungarian Database (398 patients, up to 5 years follow up)

Medication Hydrodilation +Coagulation +Medication

Only medication!

Only medication! Continuous improvement for over 2 years!

Repeated hydrodilation +coagulation after 2, 5 years better results

Hydrodilation + coagulation 4 times within 5 years Remarkable: time-to-time better result

Single hydrodilation +coagulation 6, 5 years earlier Symptomfree stable condition

Data tele-acquisition The method of collecting data to monitor the patient’s current condition enables data tele-acquisition, too. Data are sent over the Internet at individually agreed intervals The distance is naturally unlimited (example: patient in Equador) Software controls incoming data sent by the patients v If there is a delay of incoming data > 2 months patient gets automatically generated commemorative message v If the delay > 3 months, the doctor gets warning about it v Longer than 6 months delay without any feedback, patient gets excluded

Free trial version of the long-term follow-up system is available on demand If the presented system raised your interest, and you would like to test it in your everyday praxis, please let us know it and you can have a try for six months free of charge. We just ask for your feedback, your opinion, listing the failures or bugs. We are also open to your suggestions to integrate new features. Preparation of final versions, adjusted to each countries special demands can be object of future negotiations.