Key result
Text message-based telemedicine did not significantly improve depressive symptoms (change in MHI-5 score +3.0 for weekly and +0.7 for every other week vs +3.4 for standard care; P=0.70).
Why the study?
Depression is common in IBD and contributes to poor quality of life, but little is known about the impact of remote management on depressive symptoms and quality of life.
Does text message-based telemedicine improve depressive symptoms or quality of life in patients with inflammatory bowel disease compared to standard care?
RCT (n=217)
Yes
Does text message-based telemedicine improve depressive symptoms or quality of life in patients with inflammatory bowel disease compared to standard care?
Text message-based telemedicine does not significantly improve depressive symptoms or quality of life compared to standard care in IBD patients at tertiary centers.
Telemedicine does not improve depressive symptoms or QoL in IBD; challenges assumptions of remote care benefits and leaves open optimized delivery questions.
Background Depression is common in patients with inflammatory bowel disease (IBD) and contributes to poor quality of life (QoL). The use of information technology for the remote management of patients with IBD is growing, but little is known about its impact on depressive symptoms (DS) and QoL. We aimed to evaluate the impact of telemedicine on DS and generic QoL in IBD patients. Methods We analyzed data from the Telemedicine for Patients with IBD (TELE-IBD) study. During this 12-month clinical trial, patients were randomized to receive text message-based telemedicine weekly (TELE-IBD W), every other week (TELE-IBD EOW), or to standard care. Depressive symptoms and QoL were assessed over time with the Mental Health Inventory 5 (MHI-5) and the Short Form 12 (SF-12), respectively. We compared the change in MHI-5 and SF-12 (with separate physical (PCS) and mental component summary (MCS) scores) between the study arms. Results A total of 217 participants were included in this analysis. After 1 year, there was no significant difference in the change in MHI-5 (TELE-IBD W +3.0 vs TELE-IBD EOW +0.7 vs standard care +3.4; P = 0.70), MCS (TELE-IBD W +1.4 vs TELE-IBD EOW +1.0 vs standard care +2.5; P = 0.89), and PCS scores (TELE-IBD W +0.4 vs TELE-IBD EOW +0.6 vs standard care +3.7; P = 0.06) between the groups. Conclusions Text message-based telemedicine does not improve DS or QoL when compared with standard care in IBD patients treated at tertiary referral centers. Further studies are needed to determine whether telemedicine improves DS or QoL in settings with few resources.
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Schliep et al. (2020) conducted an RCT in Inflammatory bowel disease (IBD) (n=217). Text message-based telemedicine vs. Standard care was evaluated on Change in Mental Health Inventory 5 (MHI-5) score (p=0.70). Text message-based telemedicine did not significantly improve depressive symptoms (change in MHI-5 score +3.0 for weekly and +0.7 for every other week vs +3.4 for standard care; P=0.70).
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