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ORLANDO -- Patients with inflammatory bowel disease (IBD) who used a collaborative disease management app saw a significant improvement in care and quality of life (QoL), researchers reported here.
Among 320 patients with IBD, those randomized to -- an app designed to increase patient engagement and self-management skills -- reported significant improvements in quality of care over a follow-up of 575 days from baseline compared with controls (25.23 vs 30.3, P<0.001), according to Ashish Atreja, MD, MPH, of Mount Sinai School of Medicine in New York City, and colleagues.
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
The majority of patients (75%) continued to actively use the app at 575 day follow-up, he added.
"IBD patients engaging with HealthPROMISE reported more equitable participation in their care decision-making process, and showed improved health outcomes compared to patients not using HealthPROMISE," said Atreja at the Advances in Inflammatory Bowel Diseases (AIBD) meeting.
Alexandra Obremskey, MD, of Keck School of Medicine of USC in Los Angeles noted that "The more you engage patients, the greater incidence of symptoms you might see. It sounds like that's happening here ... also more active engagement isn't just bringing more attention to symptoms, but it's helping to improve the symptoms and make it a little more equitable in terms of decision-making for therapy." Obremskey was not involved in the study.
"This is excellent and important work," stated AIBD chair Miguel Regueiro, MD, of the University of Pittsburgh School of Medicine. "The HealthPromise app utilizes innovative technology to improve quality of care. These novel remote monitoring apps are the future of IBD care models."
Atreja's group randomized 162 patients to HealthPROMISE and 158 to control. Just under half were female (49.1%), the majority were white (82.2%), and 93.4% reported using the computer every day. Patients updated their information and received a disease summary in the app, while a population health coordinator monitored patient data in real time. Patients also received monthly newsletters, bi-weekly reminders on how to use the app, and bi-weekly phone calls if they hadn't updated their information.
The researchers found that anxiety (89.4%), fatigue (80.9%), and gas (57.2%) were the most commonly reported drivers of poor QoL among patients using the app.
After an average follow-up of 495 days, quality of care improved among all patients (78% vs 59% control), with a more significant increase from baseline observed among patients in the HealthPROMISE group (+28 ppt vs +9 ppt, P<0.01). A second follow-up at 575±135 days found that quality of care continued to improve in both groups (84% vs 65%), with again a more significant increase from baseline in HealthPROMISE users (+34 ppt vs +15 ppt, P<0.01).
By the 575-day marker, screening colonoscopy was the most met QoL indicator (92%) while smoking cessation screening with the least (7%).
"IBD patients are an ideal population to assess the therapeutic potential of a digital intervention used in conjunction with clinical methods for long-term IBD management," the researchers stated.
Obremskey added that such apps can provide IBD patients with more control of their condition, something that she has observed people struggling with in her own research.
Disclosures
The study was supported by the NIH.
Primary Source
Advances in Inflammatory Bowel Diseases 2017
Atreja A, et al "Improved quality of care for IBD patients using HealthPROMISE app: a randomized, control trial" AIBD 2017; Poster 003.