Abstract Background Hybrid-care models integrating digital monitoring with multidisciplinary management are emerging as novel strategies to enhance disease control and enable early detection of flares in inflammatory bowel disease (IBD). This study evaluated the impact of a hybrid-care program on clinical outcomes and assessed the accuracy of patient-reported outcome measures (PROMs) and step counts in monitoring disease activity. Methods A 12-month prospective cohort study of adult IBD patients participating in a hybrid-care program integrating a dedicated mobile application, monthly electronic PROM questionnaires, and coordinated multidisciplinary follow-up. Disease activity and quality of life were assessed monthly using validated PROMs (PRO2, SCCAI, SIBDQ, IBD Control, PROMIS-10, DASS-21) and digital step-count metrics. The primary outcome was treatment failure, defined as a composite of IBD-related hospitalization, surgery, treatment switch, or corticosteroid use. The secondary outcome was specifically IBD-related hospitalisation. Patient outcomes were compared with those of a propensity-score-matched historical cohort. Results A total of 93 patients (70 Crohn’s disease CD, 23 ulcerative colitis UC) were enrolled in the hybrid care program, and 175 patients (133 CD and 42 UC) were included in the historical cohort. Treatment failure occurred less frequently in the hybrid-care program than in the historical cohort (n = 20 21.5% vs. n = 82 46.9%, respectively; OR = 0.31 95% CI 0.17-0.55; p 0.001). IBD-related hospitalizations were also less frequent among hybrid-care participants (n = 7 7.5% vs. n = 30 17.1%, respectively; OR = 0.39 0.15-0.89; p = 0.047). Monthly IBD-specific PROMs were significantly associated with treatment failure during the same month (all p 0.001) and demonstrated moderate discriminatory accuracy (SIBDQ: AUC = 0.80; IBD-control: AUC = 0.79; PRO2/SCCAI: AUC = 0.77). In contrast, digital step count metrics, both median and relative change from baseline, were not significantly associated with treatment failure (both p 0.05) and showed weak discriminatory ability (AUC = 0.62 for both). Conclusion Implementation of a hybrid-care program for IBD was associated with improved clinical outcomes compared with standard care. Patient-reported measures, particularly IBD-specific questionnaires, outperformed digital activity metrics in identifying patients with treatment failure. These findings support the integration of structured PROM-based monitoring as a central component of hybrid-care models, while questioning the utility of digital step count metrics. References: 1. de Jong, M. J. et al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. The Lancet 390, 959–968 (2017). 2. Cross, R. K. et al. A Randomized Controlled Trial of TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD). Official journal of the American College of Gastroenterology | ACG 114, (2019). 3. Kuriakose Kuzhiyanjal, A. J. et al. Management of Inflammatory Bowel Disease Using E-health Technologies: A Systematic Review and Meta-Analysis. J Crohns Colitis 17, 1596–1613 (2023). 4. Bar-Mashiah, A. S., Mason, K., Marsiglio, M. & Lukin, D. J. Forecasting Inflammatory Bowel Disease Activity With Wearable Devices. Gastroenterology vol. 168 870–871 Preprint at https://doi.org/10.1053/j.gastro.2025.02.001 (2025). Conflict of interest: Dr. Goldman, Adam: No conflict of interest Talan Asher, Adi: No conflict of interest Goren, Moran: No conflict of interest Katz, Assaf: No conflict of interest Haj Natour, Ola: No conflict of interest Ungar, Bella: Bella Ungar has recieved lecture fees / consultation fees fro Ely Lilly, Abbvie, Takeda, Padagis Barda, Liran: No conflict of interest Tzur, May: No conflict of interest Barda, Noam: No conflict of interest Albshesh, Ahmad: received speaking and lecturing fees from Takeda, Janssen and abbvie Barkai, Galia: No conflict of interest Ukashi, Offir: NA Zimlichman, Eyal: No conflict of interest Ben-Horin, Shomron: Grant: Abbvie, Takeda, Janssen, Celltrion, Pfizer, Medtronic, Galmed, OutSense Personal Fees: Advisory board and/or consulting and/or Speaker fees from Abbvie, Takeda, Janssen, Celltrion, Pfizer, GSK, Ferring, Novartis, Roche, Gilead, NeoPharm, EviNature, Galmed, Medial Earlysign, BMS, Pfizer, Falk, Medtronic and Eli Lilly. Options/stocks in Predicta Med, Evinature, Galmed, Alma Therpeautics. Kopylov, Uri: Grant: Takeda, Janssen,Abbvie, Medtronic, Ely Lilly Other: Takeda, Janssen, Ely Lilly, Roche, Celtrion, Abbvie, Medtronic, CTS, Pfizer, BMS- speaker and advisory fees
Goldman et al. (Thu,) studied this question.