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Patients with IBD appear more receptive to text-based telemedicine
Lower attrition rates observed in a year-long study revealed that patients with inflammatory bowel disease are more receptive to an improved, text-based telemedicine program, according to study results published in the American Journal of Gastroenterology.
Raymond K. Cross, MD, MS, director of the Inflammatory Bowel Disease Program at the University of Maryland School of Medicine, and colleagues wrote that previous studies have shown telemedicine helped improve disease activity and improved quality of life in patients.
“These studies used home monitoring systems requiring installation by staff or web-based technology with associated high dropout rates,” they wrote. “We hypothesized that a new telemedicine system, utilizing cellular telephones, would result in greater adherence and decreased attrition rates. Furthermore, we hypothesized that use of an improved telemedicine system would result in decreased disease activity, improved QOL and decreased health care utilization compared to standard of care.”
Researchers recruited 348 patients (67.9% with Crohn’s disease; 42.5% with ulcerative colitis) with worsening symptoms in the prior 2 years to take part in the study. They randomly assigned patients to undergo telemedicine with monitoring texts every week (TELE-IBD weekly, n = 1160), every other week (TELE-IBD EOW, n = 115) or standard care (control, n = 117). They assessed difference in change in disease activity and QOL between the groups, as well as change in health care use as a secondary outcome.
In CD, all groups had a significant decrease in disease activity, whereas in UC, the control group was the only one to experience a significant decrease. In their assessment of QOL, researchers found that the TELE-IBD EOW group was the only group to experience a significant increase despite improvements across all groups.
Although health care use increased for all groups, both TELE-IBD groups were less likely to have IBD-related hospitalizations and had increased telephone calls compared with controls.
Although telemedicine did not result in better outcomes, Cross and colleagues wrote that the large number of recruited patients, as well as the decreased withdrawal rates — which were 13.9% to 19% compared with 44% to 59% in prior studies — show that improvement in the delivery of telemedicine resulted in better patient engagement.
“Ongoing research is also being done to determine if an improved telemedicine system with greater patient engagement can be used to improve outcomes,” they wrote. “Future studies are needed to determine if telemedicine improves outcomes in patients with IBD treated in the community and to conrm if telemedicine can be used to decrease utilization of health care resources.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.