Abstract Background Biological therapies and small molecules for patients with Inflammatory Bowel Diseases (IBD) have increased the effectiveness, but also adverse effects (AE) or problems in their administration. In addition, patients have greater formation and communication needs. In 2020, we developed a mobile application (app) to improve communication and monitoring of IBD patients. Aim and objectives To assess the implementation of an app for communication and remote monitoring with IBD patients. Methods A multidisciplinary group composed of pharmacists, dermatologists, rheumatologists, gastroenterologists, and nurses designed an app for immune-mediated inflammatory diseases (IMID) patients in a tertiary hospital. The app consists of the following modules: Medication, Questionnaires, Adverse Events, Useful Information, Messages, and Patient Profile. We offered the app to patients who initiated a new biological or small molecule therapy. We performed an observational, longitudinal study to assess the app's impact on medication adherence, safety, and communication. The inclusion period was from December 2020 to May 2024. The inclusion criteria were age ≥ 18 years, diagnosis of IBD, and ownership of a smartphone. Patients with language barriers were excluded. Results 183 patients were included (median age: 42 years [IQR: 29,5-52,1] and 47.5% were female). Concerning the type of IBD, 73.7% of patients had Crohn's Disease (CD) and 26.3% Ulcerative Colitis (UC). The median follow-up time for app use was 446 (243,5-626,5) days. In the Medication module, 100% of patients registered their biological therapy and 39 % also used this module to record each dose of medication administered. 95,1% adherent according 4-item Morisky Medication Adherence Scale (MMAS-4). A total of 98 AE were registered. 16,39% of patients registered at least 1 AE. The most frequent AEs were fatigue (28.6%), injection site reaction (16.3%), headache (13.3%), and diarrhea (8.2%). 27,3% of patients used the messages module to communicate with healthcare professionals. The most frequent messages concerned gratitude (34%), logistical and citation issues (20%), doubts about administration (14%), doubts about managing AEs (12%), and drug interactions (8%). Conclusion Our app reminds patients to take medication, enables them to record AEs, and helps them communicate with healthcare professionals. More than a third of the patients registered the administration of the biological therapies and 16,39% registered at least 1 AE. The most used functionality was communication with health professionals.
Read full abstract