P330 A prospective trial to evaluate the feasibility of a mobile app in patients with inflammatory bowel disease under maintenance therapy

Abstract

Background: The chronic character of inflammatory bowel diseases (IBD) requires close monitoring and evaluation by specialised IBD providers. Furthermore, patients increasingly seek to take part in their disease management. Telemonitoring can be implemented to enhance monitoring of disease activity, improve adherence and contribute to optimal care. Methods: An IBD mobile App was designed at a tertiary referral centre through close collaboration between the IT and gastroenterology department. Data of this mobile App are directly integrated in the electronic medical record (EMR) and a trial was established to assess the feasibility of this App. Between May and Aug 2017, the mobile App was proposed to IBD patients on maintenance therapy. Informed consent was signed and patients were followed for 6 months with weekly mobile monitoring of disease activity (patient reported outcomes, PRO-2), and monthly monitoring of adherence (MMAS-8), quality of life (SHS) and work/school productivity (WPAI). Alerts were generated in the EMR when patients experienced a flare, were hospitalised or failed to adhere. No reminders were sent to urge patients to fill out the e-questionnaires. Results: Data were collected for 45 patients (58% male, median age 34 years, 80% Crohn's disease, 20% ulcerative colitis). Twenty-five (56%) patients showed good to excellent (80-100%) completion of the weekly and monthly questionnaires during complete followup. Six (13%) patients showed good to excellent completion for 2-3 months, but lost compliance over time. Between May and Nov, 16 flare alerts were generated for 7 different patients. For 5 of them PRO-2 was increased at one occasion due to gastroenteritis. For 1 patient PRO-2 was increased twice due to low-self-reported adherence. One patient reported consecutive PRO increases, endoscopy confirmed an IBD flare and therapy was switched. Monthly reporting of medication adherence showed that four patients had low compliance once or twice. During the study period, no hospitalisations for IBD were reported. Conclusions: We report on the feasibility of a fully EMR integrated mobile PRO-based IBD App that promises to reduce clinic visits of socially and professionally active patients with IBD. Integrating reminders in the App should help to improve reporting compliance over time.