Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review

Background: Digital health is poised to transform health care and
redefine personalized health. As Internet and mobile phone usage
increases, as technology develops new ways to collect data, and as
clinical guidelines change, all areas of medicine face new
challenges and opportunities. Inflammatory bowel disease (IBD) is
one of many chronic diseases that may benefit from these advances
in digital health. This review intends to lay a foundation for
clinicians and technologists to understand future directions and
opportunities together. Objective: This review covers mobile health
apps that have been used in IBD, how they have fit into a clinical
care framework, and the challenges that clinicians and
technologists face in approaching future opportunities. Methods: We
searched PubMed, Scopus, and ClinicalTrials.gov to identify mobile
apps that have been studied and were published in the literature
from January 1, 2010, to April 19, 2019. The search terms were
(“mobile health” OR “eHealth” OR “digital health” OR
“smart phone” OR “mobile app” OR “mobile applications”
OR “mHealth” OR “smartphones”) AND (“IBD” OR
“Inflammatory bowel disease” OR “Crohn’s Disease” (CD) OR
“Ulcerative Colitis” (UC) OR “UC” OR “CD”), followed by
further analysis of citations from the results. We searched the
Apple iTunes app store to identify a limited selection of
commercial apps to include for discussion. Results: A total of 68
articles met the inclusion criteria. A total of 11 digital health
apps were identified in the literature and 4 commercial apps were
selected to be described in this review. While most apps have some
educational component, the majority of apps focus on eliciting
patient-reported outcomes related to disease activity, and a few
are for treatment management. Significant benefits have been seen
in trials relating to education, quality of life, quality of care,
treatment adherence, and medication management. No studies have
reported a negative impact on any of the above. There are mixed
results in terms of effects on office visits and follow-up.
Conclusions: While studies have shown that digital health can fit
into, complement, and improve the standard clinical care of
patients with IBD, there is a need for further validation and
improvement, from both a clinical and patient perspective.
Exploring new research methods, like microrandomized trials, may
allow for more implementation of technology and rapid advancement
of knowledge. New technologies that can objectively and seamlessly
capture remote data, as well as complement the clinical shift from
symptom-based to inflammation-based care, will help the clinical
and health technology communities to understand the full potential
of digital health in the care of IBD and other chronic
illnesses.

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Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review