Impact on Quality of Life of a Smart Device Mobile Application in Patients with Inflammatory Bowel Disease

Purpose: Web-based monitoring of Inflammatory Bowel Disease (IBD) symptoms has been shown to increase medical adherence. Smart devices (SD), such as smart phones and tablets, allow users to download many health-related apps. The use of SD has increased, and we conducted a randomized trial to determine if a mobile symptom tracking app improves QoL in IBD patients. Methods: Patients with IBD with access to a SD (iPhone®/iPad®/iPod touch® or AndroidTM) were eligible to participate. Patients with Blackberry® smart phones were excluded as the app was not fully optimized for this device. We randomized 90 patients (46 Female and 44 male) ages 20-84 with mild to moderate disease to an experimental group and control group. The experimental group downloaded a free app, GI Monitor (WellApps, New York, NY). Subjects used the app daily to record symptoms, track pain, stress levels, frequency and quality of bowel movements. The control group was educated about websites such as www.ccfa.org for information on IBD. Both groups completed the IBD Questionnaire Survey (IBDQ) at time of enrollment and again at follow-up at 8-38 weeks. Results: The mean disease duration in years was 9.5 ± 7.6 and 11.4 ± 8.5 for the control and experimental groups respectively. Mean time for follow up in person or via phone was 104 days in the control group and 87 days in the experimental group. Mean IBDQ score at times of enrollment and follow up were 158.7 ± 24.7 and 165.9 ± 24.7, and 169.3 ± 29.3 and 172.9 ± 26.8 in the control and experimental groups respectively. The change in pre to post IBDQ score was significant within control group (p<0.03) but not for the experimental group. However, the pre and post IBDQ score was not statistically significant between the two groups. The experimental group did feel that the mobile app was easy to use and subjectively improved their ability to track and correlate symptoms. Conclusion: This is the first study to investigate the use of a smart device in patients with IBD. The data from this small sample did not show comparative improvement in IBDQ scores in the experimental group over the control group. As the study patient population had long-standing IBD with a relatively good QoL at baseline, this may represent a bias toward better QoL among smart device users or improved disease awareness with increasing chronicity of disease. Our study did show that mobile apps can be successfully used in patients with mild to moderate IBD to increase their frequency of clinic visits as their disease status worsens. Further studies investigating long-term use of these tools to monitor symptoms, particularly in newly diagnosed patients, are warranted.