P801 Umbrella review of effectiveness of digital technologies for the management of Inflammatory Bowel Disease

Abstract

Abstract Background The use of digital technology is increasing significantly world wide, with 67% of the global population (5.1 billion people) having subscribed to mobile internet services in 2018 [1]. Clinical trials assessing commercially available health tools are sparse, with limited evidence-based outcome data. Systematic reviews of the randomized clinical trials (RCTs) on digital health technology in inflammatory bowel disease (IBD) performed so far, provide mixed results from highly heterogeneous studies. This umbrella review aims to investigate the effectiveness of digital health technology for the care of patients with IBD, to identify research gaps and highlight areas where future work should focus on. Methods The following databases were searched for systematic reviews published from 2012 to August 2022: PubMed and Medline via OVID, Embase via Ovid, Cochrane Library and Prospero database of systematic reviews, CINAHL via EBSCO, PsycINFO via Ovid, AMED (Allied and Complementary Medicine database) via Ovid. Electronic search results were downloaded into the “Covidence” software and screened by two reviewers independently by titles and abstracts according to the inclusion and exclusion criteria. Standardised extraction forms were established in Microsoft EXCEL. The methodological quality assessment of the included reviews was performed using AMSTAR 2.0. [2] Results The literature search identified 65 studies that were uploaded on the “Covidence” software for title and abstract screening. Three duplicates were removed. Of the 62 papers remaining, 32 were excluded based on title and abstract screening. The full text of the remaining 30 was analysed, with a resulting selection of 8 systematic reviews (four including meta-analyses) deemed relevant to this umbrella review. The RCTs on digital health technology in IBD conducted so far have identified aspects of IBD care that appear to benefit from the use of digital technology, including the patients’ satisfaction, their quality of life and quality of care, their adherence to medications and a reduced number of hospital attendances. Existing trials have not, however, been able to prove a direct benefit of using technology to achieve or maintain clinical remission (Table 1). Conclusion Telemedicine should be regarded as an important adjuvant to routine clinical practice. Future larger trials with longer follow-up and defined interventions and outcomes have the potential to address unanswered questions in this area and to identify the patients with IBD who would most benefit from telemedicine so that these approaches can be tailored to specific groups.