TELEmedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) Does Not Improve Depressive Symptoms or General Quality of Life Compared With Standard Care at Tertiary Referral Centers

Schliep, Matthew; Chudy-Onwugaje, Kenechukwu; Abutaleb, Ameer; Langenberg, Patricia; Regueiro, Miguel; Schwartz, David A.; Tracy, J. Kathleen; Ghazi, Leyla; Patil, Seema; Quezada, Sandra; Russman, Katharine; Horst, Sara; Beaulieu, Dawn; Quinn, Charlene C.; Jambaulikar, Guruprasad; Cross, Raymond K.

doi:10.1093/crocol/otaa002

Cited by 15 publications

(22 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The following publications were excluded: 12 articles because of a lack of accessible full text, 13 because of incomplete data, 7 for being unrelated to the topic, and 11 for failure of randomization; 21 conference abstracts; and 13 reviews. Finally, 17 RCTs were considered potentially eligible and comprised 2571 patients from 2010 to 2020; most of these RCTs were conducted in the United States [39][40][41][42][43][44][45], followed by the Netherlands [46][47][48], New Zealand [49,50], Denmark [12,51], the United Kingdom [52], Spain [53], Ireland [12], and Turkey [13]. The process of selecting enrolled studies is shown in Figure 1.…”

Section: Search Process Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Role of Telemedicine in Inflammatory Bowel Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials

Pang¹,

Liu²,

Liu³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

Background Telemedicine plays an important role in the management of inflammatory bowel disease (IBD), particularly during a pandemic such as COVID-19. However, the effectiveness and efficiency of telemedicine in managing IBD are unclear. Objective This systematic review and meta-analysis aimed to compare the impact of telemedicine with that of standard care on the management of IBD. Methods We systematically searched the PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus databases on April 22, 2020. Randomized controlled trials comparing telemedicine with standard care in patients with IBD were included, while conference abstracts, letters, reviews, laboratory studies, and case reports were excluded. The IBD-specific quality of life (QoL), disease activity, and remission rate in patients with IBD were assessed as primary outcomes, and the number of in-person clinic visits per patient, patient satisfaction, psychological outcome, and medication adherence were assessed as secondary outcomes. Review Manage 5.3 and Stata 15.1 were used for data analysis. Results A total of 17 randomized controlled trials (2571 participants) were included in this meta-analysis. The telemedicine group had higher IBD-specific QoL than the standard care group (standard mean difference 0.18, 95% CI 0.01 to 0.34; P.03). The number of clinic visits per patient in the telemedicine group was significantly lower than that in the standard care group (standard mean difference −0.71, 95% CI −1.07 to −0.36; P<.001). Subgroup analysis showed that adolescents in the telemedicine group had significantly higher IBD-specific QoL than those in the standard care group (standard mean difference 0.42, 95% CI 0.15 to 0.69; I2=0; P.002), but there was no significant difference between adults in the 2 groups. There were no significant differences in disease activity, remission rate, patient satisfaction, depression, self-efficacy, generic QoL, and medication adherence outcomes between the telemedicine and standard care groups. Conclusions Telemedicine intervention showed a promising role in improving IBD-specific QoL among adolescents and decreased the number of clinic visits among patients with IBD. Further research is warranted to identify the group of patients with IBD who would most benefit from telemedicine.

show abstract

Section: Search Process Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Role of Telemedicine in Inflammatory Bowel Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials

Pang¹,

Liu²,

Liu³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…A high proportion of patients were satisfied and would maintain remote monitoring; patients with IBD seem to have a good perception of telemedicine, as suggested by other studies, even if with conflicting results [32,33], and this attitude is not limited to the youngest and so-called "digital native" patients. Telemedicine could be the COVID-19 legacy in the management of IBD, aiming to reduce the cost of patients' care and rationalize the use of health resources with the standardization of infrastructures and costs [34,35]. Moreover, IBDs are heterogeneous diseases, with about half of the patients experiencing a mild disease, while 20-30% of patients develop an aggressive course: telemedicine can maintain an adequate follow-up and a satisfying patient-doctor relationship while traditional consultations are provided to severe disease and to recent-onset disease, where talking with the doctor in person is a more effective way of providing health care (need of physical examination, of point-of-care texts such as ultrasound, empathy with the doctor).…”

Section: Discussionmentioning

confidence: 99%

“…The development of more advanced platforms of telemedicine with a strict observance of GDPR (general data protection regulation) and cybersecurity rules is also warranted. Although initial investments in resources, software, training, and maintenance will be necessary at the beginning, telemedicine is going to be, in the long term, helpful for health organizations to reduce the burden associated with IBD [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Telemedicine Is an Effective Tool to Monitor Disease Activity in IBD Patients in the COVID-19 Era: A Single Centre Experience Based on Objective Data

Sinagra

Busacca

Guida

et al. 2022

Gastroenterology Insights

View full text Add to dashboard Cite

Background: The COVID-19 outbreak has led IBD clinics to adopt a remote monitoring approach in order to guarantee an adequate follow-up of patients with inflammatory bowel disease (IBD) and ensure the rules of social distancing. Aim: The aim of the study was to perform a survey on IBD patients who underwent remote monitoring in our tertiary referral center, to assess adherence, patients’ perceptions and satisfaction, and finally their opinions for future monitoring. Furthermore, we evaluated changes in disease activity and Quality of Life (QoL) using validated questionnaires. Methods: Consecutive patients with IBD scheduled for follow-up visits were switched to remote monitoring through e-mail from March 2020 to February 2021. Patients were asked to complete a questionnaire focusing on the following elements of the intervention: (1) self-assessment questions, (2) action plans, and (3) educational messages. Results: Four hundred and twenty four Caucasian patients completed the survey. 233 (55.1%) were male, 220 (52.0%) had Crohn’s Disease (CD). Median baseline Mayo Score and Harvey Bradshaw Index were 3 and 4, respectively. 9 (2.1%) patients were referred to the emergency department because of disease flares. 410 (96.9%) patients were satisfied with telemedicine, and 320 (76.5%) patients reported that they would maintain this approach also after COVID-19 pandemic. Overall, on univariate logistic regression analysis, none of the variables were related to patients’ satisfaction or to an improved QoL. The presence of ulcerative colitis was associated with the need for treatment change. Conclusions: Our results suggest that a telemedicine approach is well accepted by patients with IBD and could represent an effective tool in monitoring disease activity. Further controlled studies are warranted to properly assess if telemedicine can replace face-to-face consultations in IBD.

show abstract

“…The improvement in QoL could be attributed to the absence of hospital contacts, reducing stress for the patients in the tele-monitoring group. On one hand, the lack of clinical visits in person could only partially be replaced by the remote video assistance needed to avoid the potential risk of Covid-19 infection, and it is clear that direct interaction between clinicians and patients heavily affects the mental health and the depressive status of these patients, with downstream effects on the individual lifestyle and quality of life that are so important for the subjective patient outcome [ 13 ]. On the other hand, the possibility to contact clinicians “on demand” through the video assistant likely contributed to ensure the maintenance of the QoL parameter even in the absence of direct, classical interaction with the physician, in the overwhelmingly difficult situation of the SARS-CoV-2 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Remote Monitoring Empowerment of Patients with IBDs during the SARS-CoV-2 Pandemic

et al. 2020

View full text Add to dashboard Cite

Once the WHO declared the Sars-CoV-2 pandemic, the world had to reprogram numerous clinical activities, particularly those related to highly disabling diseases such as inflammatory bowel diseases (IBDs). In this study, 1083 IBD patients were assessed, affected by Crohn’s Disease (CD) and Ulcerative Colitis (UC), and subdivided into two groups. The first group included patients who needed treatment in person at the outpatients clinic, while the second group could be tele-monitored because they were able to self-administer therapy. The tele-monitoring was based on telecommunication applications via smartphone, driven by a dedicated clinical control room in the IBD Clinic. The aim of this study was to assess the quality of life (using IBDQ32) of UC patients and tele-monitored CD patients (tele-monitoring group) as compared to those patients who underwent assessment in person in the outpatients clinic (control group). Despite observing a lower number of relapses in the control group than the tele-monitoring group, there were no statistically significant differences between the groups in terms of the IBD32Q scores. Tele-monitoring of patients who are able to self-administer the IBD therapy can be an effective vicarious system as compared to the clinical evaluation in person, that could lead to important changes to avoid the overcrowding of the IBD outpatients clinic, especially during public health crises like the present pandemic.

show abstract

TELEmedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) Does Not Improve Depressive Symptoms or General Quality of Life Compared With Standard Care at Tertiary Referral Centers

Cited by 15 publications

References 41 publications

Role of Telemedicine in Inflammatory Bowel Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials

Role of Telemedicine in Inflammatory Bowel Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials

Telemedicine Is an Effective Tool to Monitor Disease Activity in IBD Patients in the COVID-19 Era: A Single Centre Experience Based on Objective Data

Remote Monitoring Empowerment of Patients with IBDs during the SARS-CoV-2 Pandemic

Contact Info

Product

Resources

About