P040 TEXT MESSAGE-BASED TELEMEDICINE DOES NOT IMPROVE QUALITY OF LIFE OR DEPRESSIVE SYMPTOMS IN IBD PATIENTS

Abstract

Inflammatory bowel disease (IBD) is a chronic debilitating condition involving the gastrointestinal (GI) tract that has a negative impact on quality of life (QoL). Depressive symptoms (DS) are common in affected patients and contribute to decreased QoL. Telemedicine is the use of information technology to remotely deliver health care; it is poised to gain widespread use in the care of IBD patients. However, its effect on DS and QoL is unknown in IBD. We investigated the impact of telemedicine on DS and QoL over time. This was a one-year, multicenter, randomized, controlled trial evaluating disease activity and QoL in IBD patients using text message-based telemedicine. Participants were randomized to three groups: standard of care and telemedicine weekly or every other week (EOW). Using mobile phones, telemedicine participants relayed information on their clinical symptoms and treatment plans were similarly conveyed to them. DS and QoL were measured using the Mental Health Inventory (MHI-5) and Short Form (SF-12) respectively. The SF-12 score has a physical component score (PCS) and a mental component score (MCS). Change in MHI-5 and SF-12 scores from baseline to 12 months was assessed, and comparison was made between the intervention and control groups. Of the 217 study participants, 59% were woman and 69% had Crohn’s disease. The number of participants in the control, telemedicine weekly and EOW groups were 72, 71, and 74 respectively. The baseline PCS, MCS, and MHI-5 scores were 46.9, 48.6, and 74.9 for all participants. Increase in mean PCS (p=0.0003) and MCS (p=0.04) was significant in the standard of care group over the study period. After controlling for confounding variables, there was no significant difference in the mean change in PCS (p=0.06), MCS (p=0.89), and MHI-5 (p=0.70) scores among the standard of care, weekly and EOW telemedicine groups. Text message-based telemedicine does not lead to improvement of DS or QoL when compared to standard of care in IBD patients. Although telemedicine has been shown to reduce healthcare utilization and improve access to care, caution should be exercised in overstating its benefits with regards to outcomes such as DS and QoL. Future studies should explore the impact of telemedicine on DS and QoL in other settings such as community practices.View Large Image Figure ViewerDownload Hi-res image Download (PPT)