Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review (Preprint)

Abstract

BACKGROUND Digital health is poised to transform health care and redefine personalized health. As Internet and mobile phone usage increases, as technology develops new ways to collect data, and as clinical guidelines change, all areas of medicine face new challenges and opportunities. Inflammatory bowel disease (IBD) is one of many chronic diseases that may benefit from these advances in digital health. This review intends to lay a foundation for clinicians and technologists to understand future directions and opportunities together. OBJECTIVE This review covers mobile health apps that have been used in IBD, how they have fit into a clinical care framework, and the challenges that clinicians and technologists face in approaching future opportunities. METHODS We searched PubMed, Scopus, and ClinicalTrials.gov to identify mobile apps that have been studied and were published in the literature from January 1, 2010, to April 19, 2019. The search terms were (“mobile health” OR “eHealth” OR “digital health” OR “smart phone” OR “mobile app” OR “mobile applications” OR “mHealth” OR “smartphones”) AND (“IBD” OR “Inflammatory bowel disease” OR “Crohn's Disease” (CD) OR “Ulcerative Colitis” (UC) OR “UC” OR “CD”), followed by further analysis of citations from the results. We searched the Apple iTunes app store to identify a limited selection of commercial apps to include for discussion. RESULTS A total of 68 articles met the inclusion criteria. A total of 11 digital health apps were identified in the literature and 4 commercial apps were selected to be described in this review. While most apps have some educational component, the majority of apps focus on eliciting patient-reported outcomes related to disease activity, and a few are for treatment management. Significant benefits have been seen in trials relating to education, quality of life, quality of care, treatment adherence, and medication management. No studies have reported a negative impact on any of the above. There are mixed results in terms of effects on office visits and follow-up. CONCLUSIONS While studies have shown that digital health can fit into, complement, and improve the standard clinical care of patients with IBD, there is a need for further validation and improvement, from both a clinical and patient perspective. Exploring new research methods, like microrandomized trials, may allow for more implementation of technology and rapid advancement of knowledge. New technologies that can objectively and seamlessly capture remote data, as well as complement the clinical shift from symptom-based to inflammation-based care, will help the clinical and health technology communities to understand the full potential of digital health in the care of IBD and other chronic illnesses.

The Efficiency of Internet Base Healthcare System in Gastroenterological diseases: An Updated Systematic Review

“…The use of Digital health systems such as smartphones, tablet devices, online websites, and gadgets to enhance the quality of care are swiftly transforming the practice of medical science and reshaping health care approaches. It was calculated in the last quarter of 2018, that more than 66% of the world's population are addicted to internet mobile facilities, which would cross 71% in 2025 (Yin et al 2019). A report issued by Pew Research Center, the United States in 2013 stated that last year over 71% of the internet subscribers used the internet for health-related issues (Kwan et al 2019), while 35% said that during a medical emergency and for information health they browse on the internet (Hämeen-Anttila et al 2018)It was predicted in 2015 that half of the earth's population have a healthcare application in their phone.…”