Patient self-management of inflammatory bowel disease with a smartphone app
Fifteen million people in England suffer from long-term conditions (LTCs). With the growing number of people suffering from these conditions, the pressure grows for healthcare providers to provide long-term solutions to meet this increase in demand.
Inflammatory Bowel Disease (IBD) requires frequent routine appointments, an ongoing testing regimen and costly pharmacological intervention. Moreover, people living with Crohn's disease (CD) or ulcerative colitis (UC) are often young and report that their condition leads to a significant reduction in quality of life (QOL) even when symptoms are relatively well controlled.
Barts Health NHS Trust and King's College Hospital NHS Trust in London wanted to explore how technology can help people manage their Crohn’s and colitis day-to-day and remotely (latterly in response to the impact of COVID-19 on service delivery).
To develop safe, simple monitoring and self management resources to support the replacement and enhancement of traditional outpatient appointments for patients with IBD.
Solution and impact
As part of an Innovate UK funded study, the Trusts trialled MyIBD Care, an app developed by Ampersand Health in partnership with Crohn's & Colitis UK. The app helps people manage their Crohn's and colitis day-to-day, bringing together a personal health record, daily tracking and a series of self-management courses focused on chronic symptoms, psychological wellbeing, medication adherence and lifestyle improvement.
MyIBD Care was designed for patients by patients. It was trialled in 2017 at King's College Hospital during a surveillance study which ran for 6 months and included 54 people with Crohn's or colitis.
The study demonstrated a positive user experience and a significant 85% of users stated they would prefer to use the app as the primary method of clinical contact for routine check-ups.
In a subsequent 12 month, 300 patient, Innovate UK funded service evaluation at King's College Hospital and Bart's Health, My IBD Care was found to support a safe 33% reduction in outpatient appointments in a real world setting and correspondingly, a 12-14% reduction in the overall cost of care. Early data also indicated a marked reduction in unexpected hospital admissions (a group of 14 patients with 18 admissions pre-use, experienced just 2 admissions during the study period).
- MyIBD Care’s patient management portal allows clinicians to monitor their patients using patient reported outcome measures (PROMs), trackers/wearables, home calprotectin and blood test results; automate data collection; and message securely with patients.
- My IBD Care’s patient app helps patients improve their self management through a series of behavioural science based courses focused on psychological wellbeing, lifestyle and chronic symptoms. In addition, it allows people to track medication and symptoms - including patterns of diet, sleep, exercise and pain - and to access content from the Crohn’s & Colitis Companion.
- Mobile application available for iOS and Android smartphones that allows patients to self-manage their IBD condition using behavioural science, CBT and ACT based remotely by tracking their symptoms, learning how to manage lifestyle and sending secure messages to a team of clinicians
Remote, at-home self-monitoring by patients.
Key learning points
From a hospital perspective, self-managing patients cost less to treat and reduce hospital appointments leading to shorter waiting times. MyIBD Care allows patients to submit PROMs to their clinical teams remotely and in real time, allowing clinical staff to monitor their status and intervene as required.
“Daily tracking how you're feeling, how you're eating, your stress levels, gives a certain amount of confidence that someone at the hospital is monitoring how you're doing without you having to go into the hospital every 2 months. I feel that there is an invisible person being a safety net for me. Should my condition deteriorate there is someone watching and they will catch it before it deteriorates too badly.”
Chris, 40, London, diagnosed with Colitis in 2013
Find out more
Bu Hayee, consultant gastroenterologist and co-founder MyIBD, PhD, FRCP, King's College Hospital NHS Trust
Gareth Parkes, consultant gastroenterologist and co-founder MyIBD, PhD, FRCP, Barts Health NHS Trust
Ana Ibarra, lead IBD clinical nurse specialist, Barts Health NHS Trust and Ampersand Health
Ampersand Health team
These case studies summarise user and patient experiences with digital solutions along the relevant care pathway. Unless expressly stated otherwise, the apps and digital tools referenced are not supplied, distributed or endorsed by NHSX, NHS England and NHS Improvement or the Department of Health and Social Care and such parties are not liable for any injury, loss or damage arising from their use.
All playbook case studies have either passed, or are currently undergoing the Digital Technology Assessment Criteria (DTAC) assessment.
Please note the full legal disclaimer: NHSX playbook disclaimer