Introduction Outcomes are suboptimal in ulcerative colitis (UC). Telemedicine for UC is feasible and improves outcomes. Our goals were to evaluate a home telemanagement system for UC (UC HAT) on disease activity, quality of life (QoL), and adherence compared to best available care (BAC) in a randomized, controlled trial. Materials and Methods Adults with UC were randomly assigned to receive UC HAT or BAC for 12 months. UC HAT recruits answered questions regarding disease activity, adherence, side effects, and measured their weight weekly. An educational curriculum was delivered after each session. Alerts and action plans were generated based on the results. BAC underwent routine follow up, received written action plans and were given educational fact sheets. Seo Index scores, IBDQ scores, and adherence rates were compared between UC HAT and BAC at one year. Results 25 patients were randomized to UC HAT and 22 to BAC. After 12 months, 11 withdrew in UC HAT compared to 5 in BAC. Disease activity, QoL, and adherence were not different between groups at any time point post baseline. Adjusted analyses of trial completers using all available data, demonstrated decreased Seo index (11.9 in UC HAT (p=0.08) vs. 1.2 in BAC (p=0.84) and increased IBDQ scores (12.5 in UC HAT (p=0.04) vs. to −3.8 in BAC (p=0.47) from baseline in UC HAT compared to BAC. Discussion UC HAT did not improve disease activity, QoL or adherence compared to BAC after 1 year. After adjustment for baseline disease knowledge, UC HAT trial completers experienced significant gains in disease-specific quality of life from baseline compared to BAC trial completers. Our results suggest a potential benefit of UC HAT. Further research is indicated to determine if telemedicine improves outcomes in patients with IBD.

Introduction-Outcomes are suboptimal in ulcerative colitis (UC). Telemedicine for UC is feasible and improves outcomes. Our goals were to evaluate a home telemanagement system for UC (UC HAT) on disease activity, quality of life (QoL), and adherence compared to best available care (BAC) in a randomized, controlled trial.

Effective therapies exist to treat ulcerative colitis (UC); nonadherence, inadequate monitoring, and side-effects result in suboptimal outcomes. Novel methods for monitoring are needed. Our objectives were to assess acceptance of home automated telemanagement in ulcerative colitis (UC HAT). The UC HAT system consists of a laptop connected to a scale, a decision support server, and a web-based clinician portal. The UC HAT system facilitates self-care in UC patients by monitoring patient symptoms, side-effects, and adherence, and helping patients in following their individualized treatment plans. Ten adult patients with UC were trained to use UC HAT. Attitudinal surveys and qualitative interviews were performed. The results showed that all patients reported that use of the computer was not complicated. 90% reported that the symptom diary and side-effect questions were not difficult. All patients reported that the training was adequate and 70% reported that testing took little time. Seventy percent would feel safer using the system, and 90% would agree to use UC HAT in the future. Patients felt UC HAT would keep the patient and provider up to date on changes in symptoms. Self-testing appeared to make patients accountable for managing the disease. It was discussed that improved monitoring is needed for UC. Patients with UC can be easily trained to use HAT, and patient acceptance of the UC HAT system is high. Home automated telemanagement has potential to improve clinical outcomes and patient satisfaction in UC.

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