P0983Patient Adherence to a Hybrid-Care Model for Inflammatory Bowel Disease: A Prospective Single-Center Study

Abstract

Abstract Background Hybrid care models are increasingly implemented for patients with inflammatory bowel disease (IBD) to enhance disease monitoring, optimize resource allocation, and facilitate flare detection. The success of such programs relies on sustained patient adherence. Studying adherence patterns and predictors is therefore essential for optimizing program design and identifying patients at risk of non-adherence. Methods A 12-month prospective study was conducted among IBD patients enrolled in an integrative hybrid-care program combining a dedicated mobile application, monthly electronic patient-reported outcome (PROM) questionnaires, and multidisciplinary follow-up coordinated by a specialized nurse. PROMs included the PRO2, SCCAI, SIBDQ, IBD Control, PROMIS-10, and DASS-21 questionnaires. As PRO2 (for Crohn’s disease, CD) and SCCAI (for ulcerative colitis, UC) were disease-specific indices, their scores were first categorized into active disease (PRO2≥8; SCCAI2) or remission, and then merged into a single variable for analysis. The primary outcome was PROM non-completion, defined as responding to none of the monthly questionnaires in a given month. Factors associated with PROM non-completion were assessed using univariable and multivariable logistic regression, including variables with p 0.10 from the univariable analysis. Results A total of 93 patients (70 CD, 23 UC) were enrolled in the hybrid care program. The median age was 31 (25-41) years, 57 patients (61.3%) were female, and 12 (12.9%) were current smokers. The mean monthly PROM completion rate was 55%, declining from 87% in the first month to 22% in the final month. Multivariable model confirmed follow-up duration as the strongest determinant of PROM non-completion (OR 1.26 95% CI 1.21–1.31; p 0.001). Lower baseline SIBDQ scores and higher PRO2/SCCAI scores, indicating active disease at baseline, were also associated with subsequent PROM non-completion during the study (OR = 0.98 0.97 − 1.00, p = 0.012; OR = 1.44 1.07 − 1.95, p = 0.017, respectively). Additional factors associated with PROM non-completion included smoking and marital status, as married and divorced patients participated less frequently than single patients. Notably, monthly step count metrics were not associated with PROM completion. Conclusion Program design and patient characteristics substantially influenced adherence to hybrid care. Recruitment by health-care providers achieved high initial engagement; however, the task burden of completing several questionnaires each month likely contributed to a progressive decline in participation. Implementing structured adherence protocols, with particular attention to patients presenting with active disease, may help sustain engagement. References: 1. Gordon, M. et al. Remote care through telehealth for people with inflammatory bowel disease. Cochrane Database of Systematic Reviews vol. 2023 Preprint at https://doi.org/10.1002/14651858.CD014821.pub2 (2023). 2. Delhougne, N. et al. Evaluation of the adherence of patients with chronic inflammatory bowel diseases to a PRO telemonitoring using connected devices: a prospective monocentric study. Acta Gastroenterol Belg 87, 457–467 (2024). 3. Bodger, K., Ormerod, C., Shackcloth, D. & Harrison, M. Development and validation of a rapid, generic measure of disease control from the patient’s perspective: The IBD-control questionnaire. Gut vol. 63 1092–1102 Preprint at https://doi.org/10.1136/gutjnl-2013-305600 (2014). 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