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Effect of TELEmedicine for Inflammatory Bowel Disease on Patient Activation and Self-Efficacy

  • Zaid Bilgrami
  • Ameer Abutaleb
  • Kenechukwu Chudy-Onwugaje
  • Patricia Langenberg
  • Miguel Regueiro
  • David A. Schwartz
  • J. Kathleen Tracy
  • Leyla Ghazi
  • Seema A. Patil
  • Sandra M. Quezada
  • Katharine M. Russman
  • Charlene C. Quinn
  • Guruprasad Jambaulikar
  • Dawn B. Beaulieu
  • Sara Horst
  • Raymond K. CrossJr.Email author
Original Article

Abstract

Introduction

Limitations in inflammatory bowel disease (IBD) care necessitate greater patient activation and self-efficacy, measures associated with positive health outcomes.

Methods

We assessed change in patient activation and general self-efficacy from baseline to 12 months through our TELEmedicine for IBD trial, a multicenter, randomized controlled trial consisting of a web-based monitoring system that interacts with participants via text messaging. A total of 222 adults with IBD who had experienced an IBD flare within 2 years prior to the trial were randomized into either a control arm that received standard care (SC) or an intervention arm that completed self-testing through the TELE-IBD system every other week (EOW) or weekly (W).

Results

Changes in self-efficacy scores were not significantly different between control and experimental groups. Patient activation scores were significantly different between standard care and the TELE-IBD EOW group only (p = 0.03).

Conclusions

Use of remote monitoring did not improve self-efficacy or patient activation compared to routine care.

Keywords

Telemedicine Inflammatory bowel disease Patient activation Self-efficacy 

Notes

Funding

This research was supported by the Agency for Healthcare Research and Quality (1R01HS018975-01A1) and the University of Maryland General Clinical Research Centers Program. Zaid Bilgrami was supported by the Program for Research Initiated by Students and Mentors (PRISM) at the University of Maryland School of Medicine.

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Dahlhamer JM. Prevalence of inflammatory bowel disease among adults aged ≥ 18 years—United States, 2015: MMWR. Morbidity and mortality weekly report; 2016;65.Google Scholar
  2. 2.
    Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011;140:1785–1794.CrossRefGoogle Scholar
  3. 3.
    Altschuler A, Collins B, Lewis JD, et al. Gastroenterologists’ attitudes and self-reported practices regarding inflammatory bowel disease. Inflamm Bowel Dis. 2008;14:992–999.CrossRefGoogle Scholar
  4. 4.
    Sewitch MJ, Abrahamowicz M, Barkun A, et al. Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol. 2003;98:1535.CrossRefGoogle Scholar
  5. 5.
    Jackson CA, Clatworthy J, Robinson A, Horne R. Factors associated with non-adherence to oral medication for inflammatory bowel disease: a systematic review. Am J Gastroenterol. 2010;105:525.CrossRefGoogle Scholar
  6. 6.
    Ediger JP, Walker JR, Graff L, et al. Predictors of medication adherence in inflammatory bowel disease. Am J Gastroenterol. 2007;102:1417.CrossRefGoogle Scholar
  7. 7.
    Rogala L, Miller N, Graff LA, et al. Population-based controlled study of social support, self-perceived stress, activity and work issues, and access to health care in inflammatory bowel disease. Inflamm Bowel Dis. 2008;14:526–535.CrossRefGoogle Scholar
  8. 8.
    Fishman LN, Barendse RM, Hait E, Burdick C, Arnold J. Self-management of older adolescents with inflammatory bowel disease: a pilot study of behavior and knowledge as prelude to transition. Clin Pediatr. 2010;49:1129–1133.CrossRefGoogle Scholar
  9. 9.
    Baars JE, Siegel CA, van’t Spijker A, Markus T, Kuipers EJ, van der Woude CJ. Inflammatory bowel disease-patients are insufficiently educated about the basic characteristics of their disease and the associated risk of colorectal cancer. Dig Liver Dis. 2010;42:777–784.CrossRefGoogle Scholar
  10. 10.
    Cross RK, Lapshin O, Finkelstein J. Patient subjective assessment of drug side effects in inflammatory bowel disease. J Clin Gastroenterol. 2008;42:244–251.PubMedGoogle Scholar
  11. 11.
    Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39:1005–1026.CrossRefGoogle Scholar
  12. 12.
    Hibbard JH, Mahoney ER, Stock R, Tusler M. Do increases in patient activation result in improved self-management behaviors? Health Serv Res. 2007;42:1443–1463.CrossRefGoogle Scholar
  13. 13.
    Greene J, Hibbard JH. Why does patient activation matter? an examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2012;27:520–526.CrossRefGoogle Scholar
  14. 14.
    Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191.CrossRefGoogle Scholar
  15. 15.
    Maeda U, Shen BJ, Schwarz ER, Farrell KA, Mallon S. Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. Int J Behav Med. 2013;20:88–96.CrossRefGoogle Scholar
  16. 16.
    King DK, Glasgow RE, Toobert DJ, et al. Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors. Diabetes Care. 2010;33:751–753.CrossRefGoogle Scholar
  17. 17.
    Cross RK, Finkelstein J. Feasibility and acceptance of a home telemanagement system in patients with inflammatory bowel disease: a 6-month pilot study. Dig Dis Sci.. 2007;52:357–364.  https://doi.org/10.1007/s10620-006-9523-4 CrossRefPubMedGoogle Scholar
  18. 18.
    Viers BR, Pruthi S, Rivera ME, et al. Are patients willing to engage in telemedicine for their care: a survey of preuse perceptions and acceptance of remote video visits in a urological patient population. Urology. 2015;85:1233–1240.CrossRefGoogle Scholar
  19. 19.
    Ciere Y, Cartwright M, Newman SP. A systematic review of the mediating role of knowledge, self-efficacy and self-care behaviour in telehealth patients with heart failure. J Telemed Telecare. 2012;18:384–391.CrossRefGoogle Scholar
  20. 20.
    Kim JY, Wineinger NE, Steinhubl SR. The influence of wireless self-monitoring program on the relationship between patient activation and health behaviors, medication adherence, and blood pressure levels in hypertensive patients: a substudy of a randomized controlled trial. J Med Internet Res. 2016;18:e116.CrossRefGoogle Scholar
  21. 21.
    Oddone EZ, Gierisch JM, Sanders LL, et al. A coaching by telephone intervention on engaging patients to address modifiable cardiovascular risk factors: a randomized controlled trial. J Gen Intern Med. 2018;7:1–8.Google Scholar
  22. 22.
    Cross RK, Langenberg P, Regueiro MD, et al. 903-a randomized controlled trial of telemedicine for patients with inflammatory bowel disease (Tele-IBD). Gastroenterology. 2018;154:S-177.CrossRefGoogle Scholar
  23. 23.
    Cross RK, Jambaulikar G, Langenberg P, et al. TELEmedicine for patients with inflammatory bowel disease (TELE-IBD): design and implementation of randomized clinical trial. Contemp Clin Trials. 2015;42:132–144.CrossRefGoogle Scholar
  24. 24.
    Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol. 1989;24:2–6.CrossRefGoogle Scholar
  25. 25.
    Harvey RF, Bradshaw JM. A simple index of Crohn’s-disease activity. Lancet. 1980;315:514.CrossRefGoogle Scholar
  26. 26.
    Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut. 1998;43:29–32.CrossRefGoogle Scholar
  27. 27.
    Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr Gen Appl. 1966;80:1.CrossRefGoogle Scholar
  28. 28.
    Eaden JA, Abrams K, Mayberry JF. The Crohn’s and Colitis knowledge score: a test for measuring patient knowledge in inflammatory bowel disease. Am J Gastroenterol. 1999;94:3560.CrossRefGoogle Scholar
  29. 29.
    Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care. 1991;1:169–176.CrossRefGoogle Scholar
  30. 30.
    Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Weinman J, Wright S, Windsor JM, eds. Measures in Health Psychology: A User’s Portfolio. Causal and Control Beliefs. Berkshire: NFER-NELSON; 1995:35.Google Scholar
  31. 31.
    Insigina Health. Patient activation measure (PAM) 13 TM License Materials copyright. Portland: Insigna Health LLC; 2011.Google Scholar
  32. 32.
    Trief PM, Teresi JA, Eimicke JP, Shea S, Weinstock RS. Improvement in diabetes self-efficacy and glycaemic control using telemedicine in a sample of older, ethnically diverse individuals who have diabetes: the IDEATel project. Age Ageing. 2009;38:219–225.CrossRefGoogle Scholar
  33. 33.
    Clarke J, Proudfoot J, Birch MR, et al. Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial. BMC Psychiatry. 2014;14:272.CrossRefGoogle Scholar
  34. 34.
    Michaud TL, Siahpush M, Schwab RJ, et al. Remote patient monitoring and clinical outcomes for postdischarge patients with type 2 diabetes. Popul Health Manag. 2018;21:387–394.CrossRefGoogle Scholar
  35. 35.
    Ledford CJ, Womack JJ, Rider HA, et al. Unexpected effects of a system-distributed mobile application in maternity care: a randomized controlled trial. Health Educ Behav. 2017;45:323–330.CrossRefGoogle Scholar
  36. 36.
    Scholz U, Doña BG, Sud S, Schwarzer R. Is general self-efficacy a universal construct? psychometric findings from 25 countries. Eur J Psychol Assess.. 2002;18:242.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zaid Bilgrami
    • 1
  • Ameer Abutaleb
    • 1
  • Kenechukwu Chudy-Onwugaje
    • 1
  • Patricia Langenberg
    • 1
  • Miguel Regueiro
    • 2
  • David A. Schwartz
    • 3
  • J. Kathleen Tracy
    • 1
  • Leyla Ghazi
    • 4
  • Seema A. Patil
    • 1
  • Sandra M. Quezada
    • 1
  • Katharine M. Russman
    • 1
  • Charlene C. Quinn
    • 1
  • Guruprasad Jambaulikar
    • 5
  • Dawn B. Beaulieu
    • 3
  • Sara Horst
    • 3
  • Raymond K. CrossJr.
    • 1
    Email author
  1. 1.University of Maryland School of MedicineBaltimoreUSA
  2. 2.University of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Vanderbilt University School of MedicineNashvilleUSA
  4. 4.Dartmouth–Hitchcock Medical CenterLebanonUSA
  5. 5.Brigham and Women’s HospitalBostonUSA

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