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- Review What's app? Electronic health technology in inflammatory bowel disease
- Alissa Walsh, Simon Travis
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Intestinal Research 2018;16(3):366-373.
DOI: https://doi.org/10.5217/ir.2018.16.3.366
Published online: July 27, 2018
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- Correspondence to Alissa Walsh, Translational Gastroenterology Unit, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Tel: +44-7495920267, alissa.walsh@ndm.ox.ac.uk
• Received: March 13, 2018 • Revised: May 9, 2018 • Accepted: May 10, 2018
© Copyright 2018. Korean Association for the Study of Intestinal Diseases.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
- Electronic health (eHealth) data collection is increasingly used in many chronic illnesses, to track pattern of disease. eHealth systems have the potential to revolutionize care. Inflammatory bowel disease (IBD) is a paradigm for such an approach: this is a chronic disease that usually affects young and technologically literate patient population, who are motivated to be involved in their own care. A range of eHealth technologies are available for IBD. This review considers the strengths and weaknesses of 7 platforms that focus on patient-provider interaction. These have been developed in Denmark, United States, the Netherlands, and the United Kingdom, demonstrating an international interest in this form of technology and interaction. Not only do these technologies aim to improve care but they also have the potential to collect large amounts of information. Information includes demographics and patient reported outcomes (symptoms, quality of life), quality of care (steroid use, among other metrics) and outcomes such as hospitalization. These data could inform quality improvement programmes to improve their focus. eHealth technology is also open to machine learning to analyze large data sets, through which personalized algorithms may be developed.
INTRODUCTION
eHealth TECHNOLOGY IN IBD
CONCLUSIONS
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FINANCIAL SUPPORT: The authors received no financial support for the research, authorship, and/or publication of this article.
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CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.
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AUTHOR CONTRIBUTION: Seong Jae Yeo contributed to analysis and interpretation of data, and writing and revising the manuscript. Hyun Seok Lee contributed to concept and design of the study and reviewing the manuscript. Byung Ik Jang contributed reviewing and intellectual content of the article. All authors contributed to acquisition of data and approved the final version of the manuscript for submission.
NOTES
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REFERENCES
Table 1
![ir-16-366-i001.jpg]()
Overview of eHealth Tools for IBD that Incorporate Patient-Provider Interaction
| Author (year) | Country | Intervention | IBD type (treatment) | Study design | No. of patients using eHealth tool | Control | eHealth assessments | Frequency of eHealth measurements |
|---|---|---|---|---|---|---|---|---|
| Elkjaer et al. (2010)22 | Denmark and Ireland | Constant-Care | Mild-moderate UC (5-ASA) | RCT | 169 | 164 | Disease activity: SCCAI QoL: SIBDQ |
Remission: monthly Relapse (SCCAI> 5): daily At the beginning and end of each relapse |
| Pedersen et al. (2012)31 | Denmark | Constant-Care for infliximab, to determine interval between infusions | CD (infliximab) | Cohort study | 27 | NA | Disease activity: HBI | Weekly |
| Pedersen et al. (2014)32 | Denmark | Constant-Care for 5-ASA, to guide therapy | Mild-moderate UC (5-ASA) | Cohort study | 95 | NA | Disease activity: SCCAI | Weekly |
| Cross et al. (2012)23 | USA | UC HAT (home telemanagement system) | UC (any treatment) | RCT | 25 | 22 |
Disease activity: UC symptom diary (15 questions) Weight (electronic scales) |
Weekly Weekly |
| Cross et al. (2015)33 | USA | Telemedicine using mobile phone texts to communicate with patients | UC or CD (any treatment) | RCT currently in progress | 250 Planned | 125 Planned |
Disease activity: HBI for CD SCCAI for UC Weight (electronic scales) |
Weekly or fortnightly Weekly |
| Atreja et al. (2017)34 | USA | HealthPROMISE | UC or CD (any treatment) | RCT currently in progress | 150 Planned (320 in total) | 150 Planned | QoL: SIBDQ | Fortnightly |
| de Jong et al. (2017)35 | The Netherlands | myIBDcoach | UC or CD (any treatment) | RCT | 465 | 444 | Disease activity: Monitor IBD at home questionnaire Multiple additional monthly modules: e.g., adherence, personal care plan, outpatient visit preparation | Monthly to 3 monthly |
| Walsh (2017)30 | UK | TrueColours UC (web-based system with email prompts, accessible by any device) | UC (any treatment) | Pilot study | 66 | NA | Disease activity: SCCAI QoL: IBD Control-8, EQ-5D, CUCQ8 Outcomes: ICHOM (e.g., steroid use, hospitalisation, emergency department visits) | Daily Fortnightly 3-monthly |
eHealth, electronic health; 5-ASA, 5-aminosalicylic acid; SCCAI, Simple Clinical Colitis Activity Index; QoL, quality of life; SIBDQ, Short Inflammatory Bowel Disease Questionnaire; HBI, Harvey Bradshaw Index; UC HAT, UC Home Automated Tele-management; ICHOM, International Consortium of Health Outcomes Measurement.
Figure & Data
REFERENCES
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What's app? Electronic health technology in inflammatory bowel disease
What's app? Electronic health technology in inflammatory bowel disease
Overview of eHealth Tools for IBD that Incorporate Patient-Provider Interaction
| Author (year) | Country | Intervention | IBD type (treatment) | Study design | No. of patients using eHealth tool | Control | eHealth assessments | Frequency of eHealth measurements |
|---|---|---|---|---|---|---|---|---|
| Elkjaer et al. (2010) | Denmark and Ireland | Constant-Care | Mild-moderate UC (5-ASA) | RCT | 169 | 164 | Disease activity: SCCAI QoL: SIBDQ | Remission: monthly Relapse (SCCAI> 5): daily At the beginning and end of each relapse |
| Pedersen et al. (2012) | Denmark | Constant-Care for infliximab, to determine interval between infusions | CD (infliximab) | Cohort study | 27 | NA | Disease activity: HBI | Weekly |
| Pedersen et al. (2014) | Denmark | Constant-Care for 5-ASA, to guide therapy | Mild-moderate UC (5-ASA) | Cohort study | 95 | NA | Disease activity: SCCAI | Weekly |
| Cross et al. (2012) | USA | UC HAT (home telemanagement system) | UC (any treatment) | RCT | 25 | 22 | Disease activity: UC symptom diary (15 questions) Weight (electronic scales) | Weekly Weekly |
| Cross et al. (2015) | USA | Telemedicine using mobile phone texts to communicate with patients | UC or CD (any treatment) | RCT currently in progress | 250 Planned | 125 Planned | Disease activity: HBI for CD SCCAI for UC Weight (electronic scales) | Weekly or fortnightly Weekly |
| Atreja et al. (2017) | USA | HealthPROMISE | UC or CD (any treatment) | RCT currently in progress | 150 Planned (320 in total) | 150 Planned | QoL: SIBDQ | Fortnightly |
| de Jong et al. (2017) | The Netherlands | myIBDcoach | UC or CD (any treatment) | RCT | 465 | 444 | Disease activity: Monitor IBD at home questionnaire Multiple additional monthly modules: e.g., adherence, personal care plan, outpatient visit preparation | Monthly to 3 monthly |
| Walsh (2017) | UK | TrueColours UC (web-based system with email prompts, accessible by any device) | UC (any treatment) | Pilot study | 66 | NA | Disease activity: SCCAI QoL: IBD Control-8, EQ-5D, CUCQ8 Outcomes: ICHOM (e.g., steroid use, hospitalisation, emergency department visits) | Daily Fortnightly 3-monthly |
eHealth, electronic health; 5-ASA, 5-aminosalicylic acid; SCCAI, Simple Clinical Colitis Activity Index; QoL, quality of life; SIBDQ, Short Inflammatory Bowel Disease Questionnaire; HBI, Harvey Bradshaw Index; UC HAT, UC Home Automated Tele-management; ICHOM, International Consortium of Health Outcomes Measurement.
Table 1 Overview of eHealth Tools for IBD that Incorporate Patient-Provider Interaction
eHealth, electronic health; 5-ASA, 5-aminosalicylic acid; SCCAI, Simple Clinical Colitis Activity Index; QoL, quality of life; SIBDQ, Short Inflammatory Bowel Disease Questionnaire; HBI, Harvey Bradshaw Index; UC HAT, UC Home Automated Tele-management; ICHOM, International Consortium of Health Outcomes Measurement.
