Feasibility and Acceptance of a Home Telemanagement System in Patients with Inflammatory Bowel Disease: A 6-Month Pilot Study

Our purpose was to assess the acceptance and feasibility of a home telemanagement system (HAT) in inflammatory bowel disease (IBD). The HAT consists of a laptop and a scale. Subjects were required to complete weekly self-testing for 6 months. Disease activity, quality of life, and knowledge were assessed at baseline and 6 months. Attitudinal surveys were completed at 6 months. Twenty-five subjects completed the study. Ninety-one percent of patients thought that self-testing was not complicated. Eighty-six percent said that self-testing did not interfere with their usual activities. Ninety-one percent of patients would consider using a HAT in the future. Adherence with self-testing was 91%. Improvements in disease activity and quality of life, and significant improvements in knowledge, were observed after implementation of the HAT. The HAT is feasible and accepted in IBD. We predict that the HAT will positively affect adherence, monitoring, and patient education, resulting in improved disease activity and quality of life.

[1]  R. F. Harvey,et al.  A SIMPLE INDEX OF CROHN'S-DISEASE ACTIVITY , 1980, The Lancet.

[2]  Joseph Finkelstein,et al.  Feasibility and Patients' Acceptance of Home Automated Telemanagement of Oral Anticoagulation Therapy , 2003, AMIA.

[3]  A. Cohen,et al.  Patient nonadherence to medication in inflammatory bowel disease , 2003, American Journal of Gastroenterology.

[4]  D. Mancini,et al.  Use of telemonitoring to decrease the rate of hospitalization in patients with severe congestive heart failure. , 1999, The American journal of cardiology.

[5]  Prevalence of nonadherence with maintenance mesalamine in quiescent ulcerative colitis , 2001 .

[6]  E. Irvine,et al.  The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. , 1996, The American journal of gastroenterology.

[7]  J. Lennard-jones,et al.  Classification of inflammatory bowel disease. , 1989, Scandinavian journal of gastroenterology. Supplement.

[8]  B. Johnston,et al.  Outcomes of the Kaiser Permanente Tele-Home Health Research Project. , 2000, Archives of family medicine.

[9]  Enrique J. Gómez,et al.  Telemedicine as a tool for intensive management of diabetes: the DIABTel experience , 2002, Comput. Methods Programs Biomed..

[10]  D. Thompson,et al.  Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn's disease , 2002, American Journal of Gastroenterology.

[11]  Joseph Finkelstein,et al.  Acceptance of Telemanagement is High in Patients With Inflammatory Bowel Disease , 2006, Journal of clinical gastroenterology.

[12]  T. Vontetsianos,et al.  Telemedicine-assisted home support for patients with advanced chronic obstructive pulmonary disease: Preliminary results after nine-month follow-up , 2005, Journal of telemedicine and telecare.

[13]  F. Di Mario,et al.  What do patients want to know about their inflammatory bowel disease? , 1992, The Italian journal of gastroenterology.

[14]  G. Hripcsak,et al.  Internet-based home asthma telemonitoring: can patients handle the technology? , 2000, Chest.

[15]  Joseph Finkelstein,et al.  Development and Implementation of the Home Asthma Telemonitoring (HAT) System to Facilitate Asthma Self-Care , 2001, MedInfo.

[16]  Joseph Finkelstein,et al.  Patients' acceptance of Internet-based home asthma telemonitoring , 1998, AMIA.

[17]  Joseph Finkelstein,et al.  Design and implementation of home automated telemanagement in chronic obstructive pulmonary disease , 2003, 16th IEEE Symposium Computer-Based Medical Systems, 2003. Proceedings..

[18]  C. Seal,et al.  The short inflammatory bowel disease questionnaire is reliable and responsive to clinically important change in ulcerative colitis , 2001, American Journal of Gastroenterology.

[19]  Keith Abrams,et al.  The Crohn's and colitis knowledge score: a test for measuring patient knowledge in inflammatory bowel disease , 1999, American Journal of Gastroenterology.

[20]  C. Maiolo,et al.  Home telemonitoring for patients with severe respiratory illness: the Italian experience , 2003, Journal of telemedicine and telecare.

[21]  Michal Golovner,et al.  Telecardiology for patients with chronic heart failure: the 'SHL' experience in Israel. , 2004, International journal of cardiology.

[22]  S. Hanauer,et al.  Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis. , 2003, The American journal of medicine.

[23]  A. Zinsmeister,et al.  The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. , 2001, Gastroenterology.

[24]  Sally Wells,et al.  Compliance and effectiveness of 1 year's home telemonitoring. The report of a pilot study of patients with chronic heart failure , 2001, European journal of heart failure.

[25]  G. Ferry,et al.  Guided self-management and patient-directed follow-up of ulcerative colitis: a randomised trial. , 2002, Journal of pediatric gastroenterology and nutrition.

[26]  J. Finkelstein,et al.  Evaluation of home telemanagement in adult asthma patients , 2005 .

[27]  E. Loftus Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. , 2004, Gastroenterology.

[28]  B. Avitall,et al.  Outcomes of chronic heart failure. , 2003, Archives of internal medicine.

[29]  R. Pounder,et al.  A simple clinical colitis activity index , 1998, Gut.