Telemedicine based on patient-reported outcomes in management of patients with inflammatory bowel disease in a real-life setting – a before and after cohort study

Appel, Charlotte; Pedersen, Sarah Christine; Nielsen, Amalie Søgaard; Larsen, Birgit Furstrand

doi:10.1080/00365521.2022.2041083

Cited by 11 publications

(12 citation statements)

References 38 publications

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“…PROMs have been shown to be significantly predictive of patient health status and to improve patient care [2,3]. PROMs have been developed and shown to be valuable for patient care in chronic diseases [4][5][6][7], cancer [2,[8][9][10][11][12][13][14], orthopedics [15], mental health [16], primary care [17], and infectious diseases [18][19][20][21]. PROMs used sequentially over a series of several days for patients undergoing cancer treatment enabled the patients' clinical team to monitor the patient-reported symptoms, provided the participants continuous access to self-care advice, and lessened the physical symptom distress patients experienced while improving their emotional functioning, compared to the patients randomized to usual care [13].…”

Section: Introductionmentioning

confidence: 99%

Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

Gander

Chrenka

Cromwell

et al. 2022

BMC Health Serv Res

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Background Patient reported outcome measures (PROM) can improve patient care and be crucial for symptom tracking especially during disease outbreaks. FLU-PRO Plus is a validated PROM used to track viral respiratory symptoms. Our study aimed to evaluate the feasibility of using FLU-PRO© Plus, to track symptoms across three healthcare systems. Methods The prospective, longitudinal study recruited adults between February-May 2021 from HealthPartners Institute (HP), Kaiser Permanente Georgia (KPGA), and Kaiser Permanente Mid-Atlantic States (KPMAS). Adult members were eligible if they had a positive lab or diagnosis for either COVID-19 or influenza-like illness (ILI) or exhibited 2 + viral respiratory symptoms. Descriptive statistics were calculated to describe the patient characteristics for participants that were eligible for FLU-PRO Plus, successfully contacted, attempted to log in to the FLU-PRO Plus website, and participants who completed FLU-PRO Plus Day 1. Bivariable and multivariable logistic regression using PROC GLIMMIXX investigated the patient characteristics associated with (1) successful contact and (2) FLU-PRO Plus Day 1 completion. Results We identified a total of 15,650 eligible participants during the enrollment period: 9,582 from HP, 1,740 from KPGA, and 4,328 from KPMAS. Among the total of 409 eligible adults who attempted to participate in FLU-PRO Plus, 317 completed FLU-PRO Plus Day 1. Among the 317 individuals that completed FLU-PRO Plus Day 1, 205 (67.5%) were diagnosed with COVID-19; 112 adults diagnosed with COVID-19 completed FLU-PRO Plus Day 14. Among adults successfully contacted, adults aged 35–64 (OR = 1.40, 95% CI 1.05, 1.87), females (OR = 1.77, 95% CI 1.38, 2.27), and adults diagnosed with COVID-19 (OR = 1.66, 95% CI 1.27, 2.17) had higher odds of completing FLU-PRO Plus Day 1; Asian adults (OR = 0.38, 95% CI 0.19, 0.76) and Black and African American adults (OR = 0.33, 95% CI 0.19, 0.76) had lower odds compared to White adults. Conclusion Our study reports on the feasibility of patients across three integrated healthcare systems utilizing FLU-PRO Plus to monitor their respiratory symptoms. Patient reported outcome measures (PROM) can improve patient care, quality of life, and reduce the strain of limited resources on healthcare systems. Future FLU-PRO Plus studies should develop an implementation strategy to fully integrate FLU-PRO Plus within clinical care and patient management.

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Section: Introductionmentioning

confidence: 99%

Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

Gander

Chrenka

Cromwell

et al. 2022

BMC Health Serv Res

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“…Patient-reported outcome-based telemedicine follow-up for patients with IBD has also shown a reduction in outpatient visits for patients with mild or no disease activity. [ 7 ]…”

Section: Resultsmentioning

confidence: 99%

The Use of Telemedicine in Older Patients with Gastrointestinal Diseases

Dong

Steuwe

Barry

et al. 2022

Curr Treat Options Gastro

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Purpose of Review The COVID-19 pandemic helped us understand that telemedicine provides an alternative way to manage patients remotely, with an added benefit of saving time and travel costs. However, barriers may exist in an older population of patients such as inadequate technology availability and knowledge, and lack of internet connectivity. This systematic review and analysis of data at an academic medical center examines the current literature and investigates the efficacy of telemedicine for older adults requiring gastrointestinal care. Recent Findings In the systematic review, we included 22 manuscripts from an initial 120 that were identified based on inclusion and exclusion criteria. In this existing literature, telemedicine visits were equivalent or better than in-person visits based on many metrics, including patient satisfaction, time and money saved, and standard patient outcomes. At a rural academic medical center, there was a steady decrease in the failure rate of telemedicine visits from April 2020 to May 2022 in all age groups, including the 65 + age group, from 17% in April 2020 to 3% in May 2022. Summary Telemedicine offers a comparable alternative to in-person visits that is convenient, low-cost, and does not compromise quality of care for older patients obtaining GI care. The COVID-19 pandemic has accelerated progress and uptake of telemedicine, and the successful use by all ages including older patients opens the broader conversation about the continued use of telemedicine for care in various areas of medicine.

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“…This study was part of a larger action research project [ 20 ] on patient-reported outcome concepts at an outpatient IBD clinic at Silkeborg Regional Hospital in Denmark [ 8 ]. This project has reported on patients’ perspectives on digital PRO [ 21 ]; this paper presents clinicians’ perspectives.…”

Section: Methodsmentioning

confidence: 99%

“…At the outpatient clinic for IBD at Diagnostic Centre at Silkeborg Regional Hospital (DC) which provides care to around 850 patients with IBD. 77% of patients are enrolled in the AmbuFlex IBD specific subset; AmbuIBD [ 8 ]. AmbuIBD is applied to replace face-to-face clinical follow-up consultations with Medical Doctors (MD) or Registered Nurse (RN); to prepare for a face-to-face consultation with a MD or RN; thus supporting patients in preparing and clinicians to target the issues of the consultation; and to report symptom exacerbation between consultations.…”

Section: Methodsmentioning

confidence: 99%

“…This approach aims to support treatment, care and disease management, and reduce avoidable face-to-face consultations between doctor and patient [ 6 ]. Within IBD, patients daily life experience of the disease and changes herein associates with the state of disease and possibly need of action, thereby being a suitable condition for digital PRO assessment [ 7 , 8 ]. Use of digital PROs also has the potential to increase patient empowerment and improve healthcare [ 1 , 2 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Digital patient-reported outcomes in inflammatory bowel disease routine clinical practice: the clinician perspective

Nielsen

Appel

Larsen

et al. 2022

J Patient Rep Outcomes

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Background Use of digital health services, such as digital patient-reported outcomes, depends on many different human factors as well as digital design solutions. One factor is clinicians’ attitude towards the system, their reasoning behind the using system and their perceptions of patients’ ability to engage with digital health systems. This study aimed to explore hospital clinicians’ attitudes towards digital patient-reported outcomes used in the routine care and treatment of inflammatory bowel disease, and to explore the potential role of clinicians’ attitudes in influencing patients’ use of digital patient-reported outcomes. Results Twelve clinicians using digital patient-reported outcome assessments in the care of inflammatory bowel disease were interviewed about their experiences of, and perspectives on, using this service. Most participants supported the use of digital patient-reported outcome assessments in the care of most patients. Participants reported that most patients found the digital solution easy to use. They perceived digital patient-reported outcomes to have three main purposes: prioritising resources; improving patients’ quality of life; and improving quality of care. The patient-clinician relationship was of great importance to participants. Participants varied in their intention to use digital PRO, as some viewed the system as a positive but optional add-on for patients, whilst others intended to use the system with all eligible patients. Conclusion Clinicians’ general support of using digital patient-reported outcomes might facilitate their use among patients with inflammatory bowel disease. The participants saw benefits in doing so for patients, clinicians and the wider health service. Clinicians’ attitudes towards the use of digital PRO in the care of their patients may influence patients’ uptake of health service.

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Telemedicine based on patient-reported outcomes in management of patients with inflammatory bowel disease in a real-life setting – a before and after cohort study

Cited by 11 publications

References 38 publications

Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

The Use of Telemedicine in Older Patients with Gastrointestinal Diseases

Digital patient-reported outcomes in inflammatory bowel disease routine clinical practice: the clinician perspective

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