JMIR Publications

ABSTRACT

Background:

Digital health is poised to transform healthcare and redefine personalized health. As Internet and smartphone usage increases, technology develops new ways to collect data, and clinical guidelines change, all areas of medicine face new challenges and opportunities. Inflammatory Bowel Disease (IBD) is one of many chronic diseases that may benefit from these advances in digital health. This review intends to lay a foundation for clinicians and technologists to understand future directions and opportunities together.

Objective:

This review covers digital health applications that have been used in IBD, how they have fit in to a clinical care framework, and the challenges that clinicians and technologists face approaching future opportunities.

Methods:

We searched PubMed, Scopus, and clinicaltrials.gov to identify digital health applications studied in the literature from January 1, 2010 to April 19, 2019. The search terms were “mobile health” OR “eHealth” OR “digital health” OR “smart phone” OR “mobile app” OR “mobile applications” OR “mhealth” OR “smartphones” AND "IBD" OR “Inflammatory bowel disease” OR “Crohn's Disease” OR “Ulcerative Colitis” OR “UC” OR “CD”, followed by further analysis of citations from results. We searched the Apple iTunes store to identify a limited selection of commercial applications to include for discussion.

Results:

68 articles met the inclusion criteria. 10 digital health applications were identified in the literature and 4 commercial applications were selected to be described in this review. While most applications have some educational component, the majority of applications focus on eliciting patient reported outcomes related to disease activity, and only a few are for treatment management. Significant benefits have been seen in trials relating to education, quality of life, quality of care, treatment adherence, and medication management. No studies have reported a negative impact on any of the above. There are mixed results in terms of effects on office visits and follow up.

Conclusions:

While studies have shown that digital health technology can fit into, complement, and improve the standard clinical care of patients with IBD, there is a need for further validation and improvement, from both a clinical and patient perspective. Exploring new methods of research may allow for more implementation of technology and rapid advancement of knowledge. New technologies that can objectively and seamlessly capture remote data to complement the clinical shift from symptom-based to inflammation-based care will help the clinical and health technology communities understand the full potential of digital health in the care of IBD and other chronic illnesses.