Abstract Background/Introduction Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, affects 2.4 to 3.1 million people in the United States. Biologic therapies improve outcomes, but adherence is often suboptimal, especially with home infusions or self-injections. A key gap in care is lack of real-time monitoring between visits. To address this, we developed a behavioral science based clinical hovering program, called PATH-IBD (Patient Automated Text Hovering for IBD), to engage patients, support medication adherence, and enhance communication with clinicians. Aim/Objectives We evaluated the effect of PATH-IBD on quality of life, medication adherence, patient satisfaction, and health care utilization in a randomized clinical trial. METHODS Adults with IBD (ages 18+) and receiving biologics through Home Health or self-injection were individually randomized 1:1 to control (usual care) or intervention (PATH-IBD), stratified by medication type (home infusion vs. injection). The intervention included the following components via text message: (1) biologic dose reminders, (2) medication adherence check-ins after each dose, (3) weekly symptom check-ins with escalation to the patient’s care team if above threshold, and (4) feedback to identified support partner (when applicable). Patients were enrolled for a total of 4 months. The primary outcome was change in quality of life via the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Secondary outcomes included the change in Medication Adherence Report Scale (MARS-5), patient satisfaction, proportion of days covered, and healthcare utilization. RESULTS 150 patients were enrolled; 148 completed the study, and 144 were analyzed for the survey outcomes (73 control, 71 intervention). The mean age was 38.9, 52.7% were female, and 81.1% were White. No significant differences were found between arms for the change in median score from baseline to end of study for the SIBDQ, MARS-5, or patient satisfaction surveys. Medication adherence remained high across both arms, and there was no significant difference in the proportion of days covered for infusion or injection patients between arms. There was no significant difference in outpatient visits, hospitalizations, or ED visits between arms; however, patients in the intervention arm had significantly higher number of GI-related telephone/patient portal contacts than the control (difference of 2, 95% CI 0.4–3.6, p 0.001). CONCLUSION PATH-IBD was well received and increased patient clinician communication. No improvements in quality of life, adherence, or satisfaction were observed, likely due to positive outcomes in the control group. These findings support the feasibility of digital engagement tools to strengthen clinician-patient connections. Future studies with larger, diverse populations and objective outcomes are needed.
Nguyen et al. (2026) studied this question.