eHealth strategies for IBS and IBD patients

This article is based upon the reseach paper of Ankersen et al, titled: 
Using eHealth strategies in delivering dietary and other therapies in patients with irritable bowel syndrome and inflammatory bowel disease.
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Patients suffering from IBD are often subjected to various treatment regiments as well as having to cope with regular relapses that also leads to chronic fatigue. For the society, this means direct costs suck as medication and nutrition and indirect cost because of sick leaves. Most of all, IBD has a psychological effect upon the one who has the diagnosis. It is therefore a key element in the work of Ankersen et al to reduce the relapse period and give the patient more control over their situation by developing an eHealth platform to allow patients to self-manage their disease state responses. Ankersen, who is working out of North Zealand University Hospital in Denmark, is part of a team  who have had great focus on self-assessment and home monitoring of IBD patients in order to improve patient quality of life after being diagnosed with IBS or IBD. 

According to the Copenhagen definition of eHealth, it empowers patients and enables them to screen for disease activity, as well as guide them to respond to alarm symptoms visualized by the three-color traffic light system: red (severe disease activity), yellow (mild to moderate disease activity), and green (remission)

Ankersen and the team lead by Munkholm and Burisch showed how patients could gain greater control over their situation by being able to assess their disease state themselves rather being dependent upon the physician for all assessment. In this paper, it is argued that a subjective assessement done by the patient through answering a few routine questions along with an objective measurement of disease state using the inflammatory biomarker Calprotectin through the point of care application of CalproSmart, the patient can produce a total cumulative burden score within 18 mins, giving the patient direct feedback of their own disease state and notifying the treating physician or nurse regarding their disease state within seconds through web based mobile phone app. The result of this approach was to reduce emotional stress for the patients, as well as reduce time from relapse to treatment and remission - as presented by the figure below.

Figure above is a schematic presentation of how treatment time can be drastically reduced if patients are regularly monitored. Disease relapse can be detected in preliminary stages and rapidly treated, thus reducing the disease time. Figure taken from Ankersen et al, 2017.

Home-monitoring helps the patient to be able to communicate more effectively with the treating physician and health care personnel, and overall make the treatment of symptoms easier and quicker. The patient thus will be spared for the pain and uncomfortableness of a full-blown inflammation by the time he or she gets to see the physician, and can more easily assessif a trip to the clinic or adjustment of medication (in close communication with health care personnel) is necessary or not. This will also save the patient from using unnecessary drugs, which has both physical and financial benefits, as IBD drugs rarely come without side effects while being very expensive.

It is however important to understand that no home-monitoring can be done without an objective measurement, and that is why the CalproSmart home test kit is a key tool to increase the quality of life of the patient

The effectiveness of home-monitoring has been shown in various publications. One recent publication has shown how self-assessment and home-monitoring of IBD reduced the duration of patient reaching remission after relapse from 77 days to 17 days (Elkjaer et al, 2015). There is no doubt that home-monitoring should be a necessary tool for IBD patients to keep their disease state in check. It is however important to understand that no home-monitoring can be done without an objective measurement, and that is why the CalproSmart home test kit is a key tool to increase the quality of life of the patient.



General Information

Fecal calprotectin in differential diagnosis of irritable bowel syndrome

Li XG, Lv YM, Gu F, Yang XL., Department of Gastroenterology, Peking University Third May 9, 2015

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