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Poster presentations: Clinical: Therapy and Observation 2020

P373 Telemedicine and inflammatory bowel disease: Results of the IBD assistant pilot project

K. Malickova1,2, V. Pesinova1, M. Bortlik1,3,4, D. Duricova1,3, N. Machkova1, V. Hruba1, M. Lukas1,5, K. Mitrova1,6, M. Vasatko1, M. Kostrejova1,7, M. Kolar1,5, M. Lukas1,2

1Clinical and Research Center for Inflammatory Bowel Disease, ISCARE a.s. and Charles University, Prague 7, Czech Republic, 2Institute of Medical Biochemistry and Lab Diagnostics, General University Hospital and 1st Faculty of Medicine, Prague, Czech Republic, 3Institute of Pharmacology, First Faculty of Medicine of Charles University, Prague, Czech Republic, 4Department of Internal Medicine, Military University Hospital and 1st Faculty of Medicine of Charles University, Prague, Czech Republic, 5Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic, 6Department of Pediatry, University Hospital Motol and 2nd Faculty of Medicine of Charles University, Prague, Czech Republic, 7Department of Internal Medicine, Hospital of the Sisters of Mercy of St. Borromeo, Prague, Czech Republic

Background

Telemedicine enables proper and immediate monitoring of the patient’s current health state, followed by well-timed and customised treatment. The aim of our study was to assess feasibility and safety of telemonitoring in Czech patients with inflammatory bowel disease (IBD). Furthermore, we wanted to evaluate the impact of telemonitoring on the number of outpatient′s visits and direct health-care cost.

Methods

We performed randomised controlled study including patients with IBD in stable remission on conventional therapy who were randomised either to telemonitoring (IBDA) or control (CTRL) group and were followed-up for 12 months. All IBDA patients had access to a specific web application which contained a set of questioners assessing disease activity and complications which were filled-in at least every 3 months. Evaluation of clinical activity was accompanied by measurement of faecal calprotectin (FC) at home using CalproSmart test. Individuals in the CTRL group were followed under the standard conditions as other outpatients.

Results

A total of 131 were included (42% males; 47% with Crohn′s disease) and randomised to IBDA (n = 94) or control group (n = 37). HBI/pMayo activity indexes were not significantly different at baseline (p = 0.636 and p = 0.853) and end of study (p = 0.517 and p = 0.890) in the two groups. Similarly, no significant difference in inflammatory markers (C-reactive protein, FC) was observed in either group (p>0.05). The occurrence of intercurrent infections (0.93 vs. 0.81 cases of infection/patient-year, p = 0.87) or the need for hospitalisations (1 vs. 0) was similar between the groups. The number of outpatient visits was significantly lower in the IBDA than in the CTRL group (median number in IBDA group 0, in the CTRL group 4.2 visits, respectively, p < 0.0001). Telemedicine led to a reduction in the direct annual health-care cost of patient follow-up by ~25% compared with the standard care.

Conclusion

Results of the first Czech IBD telemedicine study confirm the effectiveness and safety of the telemedicine approach, which led to a reduction in outpatient visits and savings in health-care costs while maintaining a high standard of health care.

Acknowledgements: Supported by the IBD-Comfort Endowment Fund.