P554 Impact of real world home based remote monitoring on quality of care and quality of life in inflammatory bowel disease patients: one year results of pragmatic randomized trial

Abstract

S362Poster presentations the time of initial seton placement), intermediate-term (<12 months from the time of initial seton placement), and long-term (>12 months from the time of initial seton placement) outcomes were analyzed. Results: The study cohort included 41 patients. Indication for placement of draining seton alone rather than definitive surgical fistula repair was presence of anal ulceration, stenosis and/or proctitis (n=30; 73%), complex fistulae not amenable to surgical repair (n=8; 26%) or patient preference (n=3; 7%). Concomitant medical therapy using biologics, immunomodulators, and/or steroids was used in 28 (68%), 14 (34%) and 13 (32%) patients, respectively. Median length of follow-up after seton placement was 35 months (range, 8-69). Over the short-term, 16/41 (39%) patients required additional seton placement for new or persistent fistula after median follow-up time of 2.2 months (range, 0.2-5.5 months). Over the intermediateterm, 6/37 (16%) more patients required additional seton placement for new or persistent fistula after a median follow-up time of 7.7 months (range, 7-11.4 months). Over the long-term, 7/35 (20%) more patients required additional seton placement for new or persistent fistula after a median follow-up time of 16.8 months (range, 14.5-29.5 months). Overall, 29 (71%) patients required additional seton placement for new or persistent fistula after a median time of 7 months (range, 0.2-29.5 months) after initial seton placement (Figure 1). The majority of patients requiring additional seton placement also had concomitant medical therapy with a biologic agent (19/29; 66%). Patients who had a family history of CD had a significantly lower incidence of additional seton placement (50%) compared to patients who did not have a family history of CD (90%) (p=0.04). All other clinical factors including concomitant medical therapy were not associated with additional seton placement. Conclusions: Almost 75% of patients with planned long-term seton drainage for PFCD required additional setons. These data suggest that draining setons in PFCD, even in combination with biologic agents, may not have as promising results as previously believed. Progression of PFCD remains high despite biologic therapy and seton drainage. P554 Icahn School of Medicine at Mount Sinai, Department of Medicine, New York City, United StatesBackground: Patients with IBD are ideal candidates for home-based remote monitoring care that is centered on enhanced symptom tracking and improved communication with care teams. The objective of this pragmatic randomized controlled trial is to determine the impact of the HealthPROMISE app in improving outcomes quality of care [QOC] and quality of life [QOL] as compared to a patient education app. Methods: Participants were randomized to either interventional (HealthPROMISE) or control (education app). All patients completed intake questionnaires assessing health literacy, disease severity, general health status, and demographic information. Patients in the HealthPROMISE arm were ...

Management of Inflammatory Bowel Disease Using E-health Technologies: A Systematic Review and Meta-Analysis

“…Atreja et al reported the data on use of HealthPROMISE app, a mobile cloud-based platform, in the USA in an abstract form. 44 The app recorded the QoL and symptom scores which could be tracked by HCPs and alerted them to any worsening.…”

“… 34 The HealthPROMISE app study also reported QoL as SIBDQ scores and noted significant improvement in the intervention group [ p -value not reported]. 44 Health-related QoL was measured using the IMPACT questionnaire by Young constant care, home telemonitoring, and telephone consultation studies in paediatric and adolescent patients, and no statistically significant differences were noted between study arms at the end of the follow up in all the three studies. 41 , 42 , 45 , 51 QoL scores at the end of follow up were not available in Carlsen et al ., and hence could not be included in the meta-analysis.…”

The future of telemedicine and wearable technology in IBD

“…It was demonstrated to modify treatment plans in 25% of patients, and expedited clinic visits in 21.9% of cases. A significant reduction in IBD-related hospitalisations and emergency department visits were noted during the 12-month study period, with quality of life improved in patients using the app [44].…”

What's app? Electronic health technology in inflammatory bowel disease

“…Table 1 22 23 30 31 32 33 34 35 gives an overview of eHealth tools for IBD that involve patient-provider interaction, with some information about each programme and those currently in development.…”

“…Overall QoL started to improve among those randomized to HealthPROMISE within 5 months and was consistently above the control arm through a median 18 months (495 days). 34 The responsiveness of the system is contingent on direct contact with the patient's IBD specialist team.…”