The impact of telemonitoring on the psychological well-being of patients with inflammatory bowel disease: a prospective randomized controlled study
Bibliographic record
Abstract
Background: Inflammatory bowel diseases (IBDs) are becoming increasingly prevalent worldwide. They affect not only physical, but also psychological well-being and are associated with anxiety and depression, which worsen the disease progression and reduce patients' quality of life. Fear of their disease or limited access to consistent medical care may also make a negative contribution. Telemonitoring seems to be a promising solution of this problem, as it has been shown to be effective in management of non-communicable chronic diseases. Remote monitoring provides access to educational resources and medical support regardless of a geographic distance between the patient and the doctor. It may be also considered a potential tool to support psychological well-being of IBD patients. Aim: To evaluate the impact of telemonitoring on changes over time in psychological well-being of IBD patients compared to standard care and follow-up. Methods: This was an interventional prospective randomized controlled study. The study patients were consecutively enrolled from April 2023 to April 2024 in the Department of Gastroenterology, University Clinical Hospital No. 1 (Sechenov University). The patients meeting the inclusion criteria (age over 18 years, with confirmed diagnosis of IBD, having signed a written informed consent to participate in the study) were randomized in a 1:1 ratio to either telemonitoring or standard care groups. At baseline and after 6 months of the follow-up they were assessed for the disease activity parameters (Simple Clinical Colitis Activity Index / Harvey Bradshaw Index, SCCAI / HBI questionnaire), depression and anxiety (Hospital Anxiety and Depression Scale, HADS), alexithymia (26-item Toronto Alexithymia Scale-26, TAS-26), and visceral sensitivity (Visceral Sensitivity Index, VSI) levels. The telemedicine intervention was done through a custom web platform with monthly audio check-ups to track the patients’ condition. The analysis of the questionnaires was based solely on the data from the available patients, and no missing data was imputed. Results: One hundred and sixteen (116) patients were initially enrolled into the study; 48 of them were excluded (due to pregnancy, 4; withdrawal of consent, 44), resulting in a final sample of 68 patients (30 women) with a median age of 30.5 years. There were 32 patients in the telemonitoring group and 36 in the standard care group. At baseline, 57.4% (n = 39) of the participants were in clinical remission, 47% (n = 32) exhibited anxiety or depression symptoms, 92.4% (n = 61) had visceral hypersensitivity, and 58.7% (n = 37) were alexithymic. There were no significant between-group differences at baseline. At 6 months of the follow-up, the telemonitoring group showed lower HADS and VSI scores compared to the standard care group (anxiety 5.5 vs 8, p = 0.025; depression 4 vs 6, p = 0.04; visceral sensitivity: 21.5 vs 30, p = 0.013, respectively). No significant differences between the groups were found for alexithymia or disease activity scores. Conclusion: Telemonitoring facilitates an improvement of psychological well-being in IBD patients compared to conventional face-to-face follow-up. The integration of telemonitoring into the current standards of care could enhance medical care for IBD patients, especially those with anxiety and depression symptoms or visceral hypersensitivity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.004 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".