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Remote Monitoring and Telemedicine in IBD: Are We There Yet?

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Purpose of Review

Telehealth is the delivery of health care using the most recent technological advances. With the growing complexity of inflammatory bowel disease (IBD) care, telehealth allows for delivery of specialty services to an extended population. We reviewed the most recent literature on telehealth modalities, including patient-reported and disease outcomes associated with use of telehealth.

Recent Findings

Current methods of telemedicine include telehealth, remote patient monitoring, and the use of mobile applications. Remote patient monitoring via web applications has been studied with improvement in patient-reported quality of life, medication adherence, and decreased heath care costs. Mobile applications can be used for symptom reporting and alert the medical team if a patient is reporting increased symptoms. These web and mobile applications allow for treatment decisions to occur without the delay of an office visit. There remain limitations to telehealth including technological concerns, physician acceptance, and licensing and reimbursement inequities.


Telemedicine is a safe, effective, and accepted method of meeting the growing demand for complex IBD care throughout the world. The use of telehealth video conference and remote patient monitoring with web-based applications and text messaging has been shown to ease financial burdens of chronic disease, improve patient quality of life, and lead to improved clinical outcomes.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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    Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥18 years—United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166–9.

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    Telehealth Basics. American Telemedicine Association. Available from: Accessed 25 July 2019.

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    Aguas Peris M, del Hoyo J, Bebia P, Faubel R, Barrios A, Bastida G, et al. Telemedicine in inflammatory bowel diseases: opportunities and approaches. Inflamm Bowel Dis. 2015;21(2):392–9.

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    Li SX, Thompson KD, Peterson T, Huneven S, Carmichael J, Glazer FJ, et al. Delivering high value inflammatory bowel disease care through telemedicine visits. Inflamm Bowel Dis. 2017;23(10):1678–81.

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    Pedersen N, Elkjaer M, Duricova D, Burisch J, Dobrzanski C, Andersen NN, et al. eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease. Aliment Pharmacol Ther. 2012;36:840–9.

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    Carlsen K, Jakobsen C, Houen G, Kallemose T, Paerregaard A, Riis LB, et al. Self-managed eHealth disease monitoring in children and adolescents with inflammatory bowel disease: a randomized controlled trial. Inflamm Bowel Dis. 2017;23(3):357–65.

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    Del Hoyo J, et al. A web-based telemanagement system for improving disease activity and quality of life in patients with complex inflammatory bowel disease: pilot randomized controlled trial. J Med Internet Res. 2018;20(11):e11602.

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    Singh S, et al. Project Sonar: a community practice-based intensive medical home for patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2018;16:1847–50.

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    •• De Jong MJ, et al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre randomised controlled trial. Lancet. 2017;390(10098):959–68 This is the large RCT in which patients received complete telehealth care in place of standard outpatient visits, with decreased health care utilization and increased medication adherence.

  14. 14.

    •• Cross RK, et al. A randomized controlled trial of TELEmedicine for patients with inflammatory bowel disease (TELE-IBD). Am J Gastroenterol. 2019;114:472–82 This randomized controlled trial is the largest US, multicenter study that demonstrated the feasibility of telemedicine, and decrease in hospitalizations.

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    Abutaleb A, et al. Inflammatory bowel disease telemedicine clinical trial: impact of educational text messages on disease-specific knowledge over 1 year. Inflamm Bowel Dis. 2018;24(10):2191–7.

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    Bilgrami Z, Abutaleb A, Chudy-Onwugaje K, Langenberg P, Regueiro M, Schwartz DA, et al. Effect of TELEmedicine for inflammatory bowel disease on patient activation and self-efficacy. Dig Dis Sci. 2019;65:96–103.

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    Chudy-Onwugaje K, Abutaleb A, Buchwald A, Langenberg P, Regueiro M, Schwartz DA, et al. Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2018;24(12):2648–54.

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    Connolly Quinn C, et al. The telemedicine for patients with inflammatory bowel disease (Tele-IBD) clinical trial: qualitative assessment of participants’ perceptions. J Med Internet Res. 2019;21(6):e14165.

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    Mobile Fact Sheet. Pew Research Center. Available from: Accessed 30 July 2019.

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    Kelso M, Feagins LA. Can smartphones help deliver smarter care for patients with inflammatory bowel disease? Inflamm Bowel Dis. 2018;34(7):1453–9.

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    Van Deen W, et al. Development and validation of an inflammatory bowel diseases monitoring index for use with mobile health technologies. Clin Gastroenterol Hepatol. 2016;14:1742–50.

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    Kim ES, Park KS, Cho KB, Kim KO, Jang BI, Kim EY, et al. Development of a web-based, self-reporting symptom diary for Crohn’s disease, and its correlation with the Crohn’s disease activity index. J Crohns Colitis. 2017;11(12):1449–55.

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    •• Kim ES, et al. Disease activity patterns recorded using a mobile monitoring system are associated with clinical outcomes of patients with Crohn’s disease. Dig Dis Sci. 2018;63:2220–30 This study highlights the use of mobile symptom diary reporting to decrease disease-related outcomes including hospitalizations and bowel surgery.

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Correspondence to Raymond K. Cross.

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The authors declare that they have no conflict of interest.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of Topical Collection on Inflammatory Bowel Disease

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George, L.A., Cross, R.K. Remote Monitoring and Telemedicine in IBD: Are We There Yet?. Curr Gastroenterol Rep 22, 12 (2020).

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  • Telehealth
  • Remote monitoring
  • Mobile health applications
  • Inflammatory bowel disease