EHealth Technologies in Inflammatory Bowel Disease: A Systematic Review

J Crohns Colitis. 2016 Sep;10(9):1103-21. doi: 10.1093/ecco-jcc/jjw059. Epub 2016 Feb 29.


Background and aims: Electronic-health technologies (eHealth) such as Web-based interventions, virtual clinics, smart-phone applications, and telemedicine are being used to manage patients with inflammatory bowel disease (IBD). We aimed to: (1) Evaluate the impact of eHealth technologies on conventional clinical indices and patient-reported outcome measures (PROs) in IBD; (2) assess the effectiveness, cost-effectiveness and feasibility of using eHealth technologies to facilitate the self-management of individuals with IBD, and; (3) provide recommendations for their design and optimal use for patient care.

Methods: Relevant publications were identified via a literature search, and 17 publications were selected based on predefined quality parameters.

Results: Six randomized controlled trials and nine observational studies utilizing eHealth technologies in IBD were identified. Compared with standard outpatient-led care, eHealth technologies have led to improvements in: Relapse duration [(n = 1) 18 days vs 77 days, p < 0.001]; disease activity (n = 2); short-term medication adherence (n = 3); quality of life (n = 4); IBD knowledge (n = 2); healthcare costs (n = 4); the number of acute visits to the outpatient clinic due to IBD symptoms (n = 1), and; facilitating the remote management of up to 20% of an IBD cohort (n = 2). Methodological shortcomings of eHealth studies include heterogeneity of outcome measures, lack of clinician/patient input, lack of validation against conventional clinical indices and PROs, and limited cost-benefit analyses.

Conclusions: EHealth technologies have the potential for promoting self-management and reducing the impact of the growing burden of IBD on health care resource utilization. A theoretical framework should be applied to the development, implementation, and evaluation of eHealth interventions.

Keywords: EHealth; inflammatory bowel disease; remote consultation; self-management; telemedicine.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Canada
  • Cost-Benefit Analysis
  • Europe
  • Humans
  • Inflammatory Bowel Diseases / economics
  • Inflammatory Bowel Diseases / therapy*
  • Internet
  • Outcome Assessment, Health Care
  • Quality Assurance, Health Care
  • Self Care
  • Telemedicine / economics
  • Telemedicine / methods*
  • Telemedicine / standards
  • United States