Telemedical follow-up in patients with inflammatory bowel diseases

Abstract

Inflammatory bowel diseases (IBDs) represent a group of nosologies including Crohns disease and ulcerative colitis. These diseases lead both to the deterioration of the patients physical condition and to a pronounced decrease in the quality of life. Currently, healthcare costs of managing patients with IBDs are steadily increasing and are commonly associated with the need for examinations and therapy with expensive drugs and unplanned expenses of healthcare resources for unscheduled consultations, emergency hospitalizations, and surgical interventions. Deterioration of patients condition may be associated with self-cancellation of therapy after normalization of the state of health. The use of telemedical technologies (TMTs) is promising for maintaining remission of IBDs, improving adherence to therapy, and reducing the frequency of unscheduled visits to the clinic and the cost of treating IBD complications (including surgery). The efficiency and benefits of TMTs in patients with IBDs were assessed in comparison with standard face-to-face follow-up. A literature search relevant to the review was conducted in the PubMed database. Papers were selected that assessed the efficiency of telemedical interventions among patients with IBDs as compared to the standard face-to-face follow-up group. The evaluation criteria included the degree of the disease activity, risks of IBD recurrence, quality of life of patients, adherence to therapy, healthcare costs, and frequency of visits to healthcare facilities. Telemedical interventions were conducted using the Internet, mobile applications, various telemedical platforms, SMS messages, and phone calls. The telemedical follow-up groups received access to educational materials and online consultations with a specialist upon request and completed questionnaires to assess disease activity, adherence to therapy, and quality of life. The degree of IBD activity and risk of recurrence and the level of adherence to therapy did not differ significantly between the telemedical intervention and standard face-to-face follow-up groups. The study by L. Pang et al. showed that the patients quality of life in the group of telemedical intervention was significantly higher (p=0.03) [8]. Another advantage of using TMTs is the provision of access to educational materials about IBDs and the possibility of remote contact with the treating physician. The patients ability to obtain necessary information reduces the need for unplanned visits to medical facilities and the cost of organizing medical care for patients with IBDs. The use of TMTs allows to monitor IBD activity as effectively as face-to-face follow-up, improve the patients quality of life with IBDs, and reduce costs for organizing care for patients with these diseases by decreasing the frequency of unscheduled visits to the doctor and conducting unnecessary additional examinations.

Keywords

• telemedicine
• telemonitoring
• ehealth
• inflammatory bowel diseases