Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

A Correction to this article was published on 02 December 2019

This article has been updated

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Change history

  • 02 December 2019

    This manuscript is a secondary analysis of a large multicenter randomized controlled trial. The primary study is Cross RK et al., A Randomized Controlled Trial of TELEmedicine for patients with Inflammatory Bowel Disease (TELE-IBD). Am J Gastroenterol, 2019 Mar.

  • 02 December 2019

    This manuscript is a secondary analysis of a large multicenter randomized controlled trial. The primary study is Cross RK et al., A Randomized Controlled Trial of TELEmedicine for patients with Inflammatory Bowel Disease (TELE-IBD). Am J Gastroenterol, 2019 Mar.

References

  1. Dahlhamer JM. Prevalence of inflammatory bowel disease among adults aged ≥ 18 years—United States, 2015: MMWR. Morbidity and mortality weekly report; 2016;65.

  2. Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011;140:1785–1794.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  4. Sewitch MJ, Abrahamowicz M, Barkun A, et al. Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol. 2003;98:1535.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  6. Ediger JP, Walker JR, Graff L, et al. Predictors of medication adherence in inflammatory bowel disease. Am J Gastroenterol. 2007;102:1417.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  14. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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. 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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  24. Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol. 1989;24:2–6.

    Article  Google Scholar 

  25. Harvey RF, Bradshaw JM. A simple index of Crohn’s-disease activity. Lancet. 1980;315:514.

    Article  Google Scholar 

  26. Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut. 1998;43:29–32.

    Article  CAS  Google Scholar 

  27. Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr Gen Appl. 1966;80:1.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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. Insigina Health. Patient activation measure (PAM) 13 TM License Materials copyright. Portland: Insigna Health LLC; 2011.

    Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. University of Maryland School of Medicine, 685 West Baltimore Street, Suite 8-00, Baltimore, MD, 21201, USA

    Zaid Bilgrami, Ameer Abutaleb, Kenechukwu Chudy-Onwugaje, Patricia Langenberg, J. Kathleen Tracy, Seema A. Patil, Sandra M. Quezada, Katharine M. Russman, Charlene C. Quinn & Raymond K. Cross Jr.

  2. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Miguel Regueiro

  3. Vanderbilt University School of Medicine, Nashville, TN, USA

    David A. Schwartz, Dawn B. Beaulieu & Sara Horst

  4. Dartmouth–Hitchcock Medical Center, Lebanon, NH, USA

    Leyla Ghazi

  5. Brigham and Women’s Hospital, Boston, MA, USA

    Guruprasad Jambaulikar

Authors
  1. Zaid Bilgrami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ameer Abutaleb
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenechukwu Chudy-Onwugaje
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Langenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miguel Regueiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David A. Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Kathleen Tracy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leyla Ghazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seema A. Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sandra M. Quezada
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katharine M. Russman
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Charlene C. Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Guruprasad Jambaulikar
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Dawn B. Beaulieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Sara Horst
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Raymond K. Cross Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raymond K. Cross Jr..

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bilgrami, Z., Abutaleb, A., Chudy-Onwugaje, K. et al. Effect of TELEmedicine for Inflammatory Bowel Disease on Patient Activation and Self-Efficacy. Dig Dis Sci 65, 96–103 (2020). https://doi.org/10.1007/s10620-018-5433-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-018-5433-5

Keywords

Search

Navigation