Telemedicine reduces outpatient visits, hospital admissions for IBD patients

Last Updated: 2017-08-02

By Reuters Staff

NEW YORK (Reuters Health) - Patients with inflammatory bowel disease (IBD) have fewer outpatient visits and hospital admissions when they use a telemedicine system for managing their care, new findings show.

"In an era of health-care cost reduction and a rising incidence of inflammatory bowel disease, telemedicine systems could be a valuable tool for reorganizing inflammatory bowel disease care towards more personal and value-based health care," Dr. Marieke Pierik of Maastricht University Medical Center in The Netherlands and colleagues write in their report, online July 14 in The Lancet.

To date, studies of telemedicine for patients with IBD have been done only in patients with ulcerative colitis, and it is unclear if they apply to other IBD subtypes, Dr. Pierik and her colleagues write.

To address the issue, they developed an application for tablet and smartphone called myIBDcoach that monitors and registers disease activity in patients with any type of IBD. The system also monitors treatment adherence, psychosocial factors, smoking and nutrition, and includes interactive e-learning modules on several topics.

IBD patients at four Dutch hospitals (two academic, two non-academic) were randomly assigned to myIBDcoach (465 patients) or standard care (444 patients) and followed for a year.

At 12 months, the mean total number of outpatient visits to a gastroenterologist or nurse were 1.55 with myIBDcoach, compared to 2.34 for the standard care group (p<0.0001). The mean number of hospital admissions was 0.05 versus 0.10 (p=0.046), respectively. Medication adherence was also better in the telemedicine group.

Both groups reported similarly high levels of quality of care. There were no significant differences between the groups in the number of flares, corticosteroid courses, emergency visits or surgeries.

"These results are in line with the improved care and monitoring with telemedicine in other (relapsing-remitting) chronic diseases, such as chronic obstructive pulmonary disease and heart failure," Dr. Pierik and her team write.

They conclude: "Trials with longer follow-up periods are required to determine whether the telemedicine system can control costs and improve long-term disease outcomes."

"In view of the heterogeneity of these disorders and the complexity and variability of their treatments, these findings are a remarkable achievement," Dr. Thomas Ullman and Dr. Ashish Atreja of the Icahn School of Medicine at Mount Sinai in New York City write in an editorial accompanying the study. "We look forward to seeing new applications that will reduce symptoms, promote convenience, and keep patients well at home, work, or school."

Dr. Pierik was not available for an interview by press time.

SOURCE: http://bit.ly/2wkPsQr and http://bit.ly/2u37hHl

Lancet 2017.