Del Hoyo J, Millán M, Garrido-Marín A, Aguas M. Are we ready for telemonitoring inflammatory bowel disease? A review of advances, enablers, and barriers. World J Gastroenterol 2023; 29(7): 1139-1156 [PMID: 36926667 DOI: 10.3748/wjg.v29.i7.1139]
Corresponding Author of This Article
Mónica Millán, MD, PhD, Doctor, Staff Physician, Department of Surgery, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell, Valencia 46026, Spain. monicamillan72@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 21, 2023; 29(7): 1139-1156 Published online Feb 21, 2023. doi: 10.3748/wjg.v29.i7.1139
Are we ready for telemonitoring inflammatory bowel disease? A review of advances, enablers, and barriers
Javier Del Hoyo, Mónica Millán, Alejandro Garrido-Marín, Mariam Aguas
Javier Del Hoyo, Alejandro Garrido-Marín, Mariam Aguas, Department of Gastroenterology, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
Mónica Millán, Department of Surgery, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
Mariam Aguas, Health Research Institute La Fe, La Fe University and Polytechnic Hospital, Valencia 46026, Spain
Author contributions: Del Hoyo J designed the research study; Del Hoyo J and Garrido-Marín A performed the research; all authors wrote the manuscript; all authors read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mónica Millán, MD, PhD, Doctor, Staff Physician, Department of Surgery, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell, Valencia 46026, Spain. monicamillan72@gmail.com
Received: September 21, 2022 Peer-review started: September 21, 2022 First decision: October 18, 2022 Revised: November 2, 2022 Accepted: February 9, 2023 Article in press: February 9, 2023 Published online: February 21, 2023 Processing time: 152 Days and 14.6 Hours
Abstract
This review summarizes the evidence about telemonitoring in patients with inflammatory bowel disease (IBD). To give an overview of the advances performed, as well as the enablers and barriers which favoured/hindered telemonitoring implementation. We performed a literature search in PubMed, EMBASE, MEDLINE, Cochrane Database, Web of Science and Conference Proceedings. Titles and abstracts published up to September 2022 were screened for a set of inclusion criteria: telemonitoring intervention, IBD as the main disease, and a primary study performed. Ninety-seven reports were selected for full review. Finally, 20 were included for data extraction and critical appraisal. Most studies used telemonitoring combined with tele-education, and programs evolved from home telemanagement systems towards web portals through mHealth applications. Web systems demonstrated patients’ acceptance, improvement in quality of life, disease activity and knowledge, with a good cost-effectiveness profile in the short-term. Initially, telemonitoring was almost restricted to ulcerative colitis, but new patient reported outcome measures, home-based tests and mobile devices favoured its expansion to different patients´ categories. However, technological and knowledge advances led to legal, ethical, economical and logistic issues. Standardization of remote healthcare is necessary, to improve the interoperability of systems as well as to address liability concerns and users´ preferences. Telemonitoring IBD is well accepted and improves clinical outcomes at a lower cost in the short-term. Funders, policymakers, providers, and patients need to align their interests to overcome the emerging barriers for its full implementation.
Core Tip: In this review we focus on the advances performed in telemonitoring of patients with inflammatory bowel disease, taking into consideration the elements which enabled its use and how technological achievements led to other barriers for its full implementation. We detail the impact of telemonitoring on health outcomes and its cost-effectiveness. We also describe the advances on new patient-reported outcome measures, home-based tests and wearables which improve the ability to manage new patients´ profiles remotely. However, during the pandemic, e-mail and telephone still represented the main resources used. Then, we describe the emerging barriers which explained the limited application of mature telemonitoring programs.
