P292. Smart phones for inflammatory bowel disease
L. Patience1, A. Watson2, 1Centre of Health Science, Research and Development, Inverness, United Kingdom, 2Raigmore Hospital/Centre of Healt Science, Colorectal Surgery/Research and Development, Inverness, United Kingdom
The Highlands and islands of Scotland is a large geographical area. There are over 600 patients with Infalmmatory bowel disease (IBD) living within NHS Highland, they can be a 4 hour car journey from appropriate secondary care. In addition to the geographical challenge to general practitioners who may have only one patient with crohns or colitis in the practice.
We have designed and built software that displays the transferred data so that it can be interpreted by the research team. Each patient has an “app” downloaded to their phone and is asked to complete a daily diary. A range of symptoms are then displayed graphically, and if any of the symptoms deviate form the normal level the IBD nurse is alerted and holds a consultation with the patient ensureing that the appropriate care is sought as quickly as possible.
Forty patients have been recruited from accross the Highlands. Some live in urban areas and some live in remote locations. We aim to measure if the use of the “smart phone app” improves patient health and wellbeing and leads to more personalised care. We will use a variety of measures to record what impact the technology has on their disease, quality of life and the number of contacts with their GP and hospital doctor.
Two focus groups, one with participating clinicians and with a sample of participating patients have been conducted by an external qualitative researcher. Interviews were recorded, coded and analysed in Nvivo using a framework approach. The nurse specialist was also present to facilitate the groups and answer specific questions of fact about the pilot.
Patients varied in age, gender and experience of smart phones and new technolgies. Some already had been collecting information on stand-alone applications. Both patients and clinicians found the app easy to use despite some issues around connectivity. All patients reported using the app every day with only some minor exceptions. Both groups felt self monitoring transformed susequent clinical encounters as both parties had a comprehensive history to hand. Patients felt reassured that their symptoms were monitored by a specialist nurse at least weekly and the added contact availability from the main hospital if they required it. Some patients expressed a desire to collect more information.
The results of the focus group study showed that the smart phone application is working well in its early stages. The key defining features of success were:
- The abilty of patients to transmit data directly to the clinical team.
- The integration of the application into the healthcare delivery.
- The motivation of the patients to collect their data about their disease.
This innovative model could be extended to a range of other chronic conditions.