Smartphone-based videoconference visits are easy to implement, effective, and feasible in Crohn's disease patients: a prospective cohort study

Abstract

Aim: Crohn's disease patients require life-long follow-up resulting in frequent hospital visits. The benefits of telehealth have been established in the remote management of Crohn’s disease but the role of mobile technology is missing. Our goal was to determine the feasibility and effectiveness of smartphone-based real-time video visits. Material and Method: We followed 139 patients with either traditional (FTF) or online clinics (OLV) at a university hospital between May 2020- December 2020. We measured patients' satisfaction, disease activity, visit outcomes, socioeconomic parameters, and travel expenses to assess the effectiveness and acceptance of OLV. Results: Satisfaction scores were significantly higher at OLV compared to FTF (89.58±9.93 vs 70.85±18.51, p<0.001). The Cronbach Alpha reliability coefficient of the VSQ9 scale was 0.878. A median of 47 km travel distance with a median travel time of 49 minutes per visit were saved with OLV. In terms of travel costs there was a potential saving of an average of US$12.24 per appointment. Eighty-five percent of the patients were successfully managed with online visits and did not require face-to-face visit. Conclusion: There was a high level of acceptance for Smartphone-based real-time video visits in the distant management of Crohn’s disease. The telehealth model was easy to implement, effective, with significant savings in travel costs and time.

Keywords

• Crohn
• Telehealth
• COVID-19
• Cost of care

Supporting Institution

None

References

1. Burisch J, Jess T, Martinato M, Lakatos PL. The burden of inflammatory bowel disease in Europe. J Crohn’s Colitis 2013; 7: 322–37.
2. Borren NZ, Conway G, Tan W, et al. Distance to specialist care and disease outcomes in inflammatory bowel disease. Inflamm Bowel Dis 2017; 23: 1234–9.
3. Danese S, Fiorino G, Peyrin-Biroulet L. Early intervention in Crohn’s disease: Towards disease modification trials. Gut 2017; 66: 2179–87.
4. Mosli M, Alourfi M, Alamoudi A, et al. A cross-sectional survey on the psychological impact of the COVID-19 pandemic on inflammatory bowel disease patients in Saudi Arabia. Saudi J Gastroenterol 2020; 26: 263.
5. Elkjaer M, Shuhaibar M, Burisch J, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided ‘Constant-care’ approach. Gut 2010; 59: 1652-61.
6. Cross RK, Finkelstein J. Feasibility and acceptance of a home telemanagement system in patients with inflammatory bowel disease: a 6-month pilot study. Dig Dis Sci 2007; 52: 357–64.
7. Habashi P, Bouchard S, Nguyen GC. Transforming access to specialist sare for inflammatory bowel disease: The PACE telemedicine program. J Can Assoc Gastroenterol 2019; 2: 186–94.
8. Kennedy DM, Robarts S, Woodhouse L. Patients are satisfied with advanced practice physiotherapists in a role traditionally performed by orthopaedic surgeons. Physiother Can 2010; 62: 298–305.

9. Harvey RF, Bradshaw JM. A simple index of Crohn's disease activity. Lancet 1980; 315: 514.
10. Krier M, Kaltenbach T, McQuaid K, Soetikno R. Potential use of telemedicine to provide outpatient care for inflammatory bowel disease. Am J Gastroenterol 2011; 106: 2063–7.
11. Webrazzi Summit 2019 n.d.: 634. https://webrazzi.com /2019/10/24/turkiye-mobil-uygulama-kullanici-sayisi-gemius/ Gozde U. (accessed January 22, 2021).
12. Con D, Jackson B, Gray K, De Cruz P. eHealth for inflammatory bowel disease self-management - the patient perspective. Scand J Gastroenterol 2017; 52: 973–80.
13. Cimperman M, Makovec Brenčič M, Trkman P. Analyzing older users’ home telehealth services acceptance behavior—applying an Extended UTAUT model. Int J Med Inform 2016; 90: 22–31.
14. Cross RK, Langenberg P, Regueiro M. et al. A randomized controlled trial of TELEmedicine for patients with inflammatory bowel disease (TELE-IBD). Am J Gastroenterol 2019; 114: 472–82.
15. Ruf B, Jenkinson P, Armour D, Fraser M, Watson AJ. Videoconference clinics improve efficiency of inflammatory bowel disease care in a remote and rural setting. J Telemed Telecare 2020; 26: 545–51.
16. Wade VA, Karnon J, Elshaug AG, Hiller JE. A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Serv Res 2010; 10: 233.