Year: 2011
Type: book-chapter
Study design: Systematic Review
Abstract: According to 2004 statistics from the National Digestive Diseases Information Clearinghouse, digestive diseases affect 60-70 million people in the United States, resulting in 105 million ambulatory visits and 13.5 million hospitalizations.The cost burden associated with these diseases is high.It is estimated that direct and indirect medical costs related to digestive diseases are $98 billion and $44 billion, respectively.Chronic digestive diseases make up a significant proportion of these disorders, including but not limited to celiac disease, chronic constipation, chronic pancreatitis, cirrhosis, Crohn's disease, gastroesophageal reflux disease, irritable bowel syndrome, ulcerative colitis, and viral hepatitis.Telemedicine has been used successfully in chronic conditions such as asthma, diabetes, and congestive heart failure.In patients with asthma, telemedicine improves symptoms, decreases use of quick relief inhalers, improves adherence with self-action plans, improves quality of life and patient knowledge, and decreases urgent care visits (Joshi et al, 2005).In diabetes, telemedicine reduces glycosylated hemoglobin levels (Quinn et al, 2009).Telemedicine improves quality of life, and decreases hospitalizations and costs in congestive heart failure (Roth et al, 2004).Telemedicine has proven to be a feasible and well accepted method of treatment delivery in the field of gastroenterology as well.A systematic review of scientific publications was performed in order to identify all studies conducted examining the application of telemedicine in digestive diseases.Database searches in MEDLINE, the Cochrane Controlled Trials Register, and Web of Science Conference Proceedings Citation Index were done with the following search terms: telemedicine, gastroenterology, inflammatory bowel disease, ulcerative colitis, Crohn's disease, gastroesophageal reflux disease, hepatitis C, hepatitis B, chronic liver disease, cirrhosis, constipation, irritable bowel syndrome, microscopic colitis, celiac disease and chronic pancreatitis.This search yielded telemedicine studies conducted in one of three disease states: inflammatory bowel disease with a specific focus in ulcerative colitis, irritable bowel syndrome, and chronic viral hepatitis C. In this chapter, we will review the use of telemedicine for these chronic digestive diseases and the effect of telemedicine on access to care, disease activity, education, and quality of life. www.intechopen.comTelemedicine Techniques and Applications 348 Inflammatory bowel diseaseMany of the telemedicine studies in digestive diseases focuses on the chronic disease model of inflammatory bowel disease (IBD).IBD is comprised of ulcerative colitis (UC) and Crohn's disease (CD), two inflammatory conditions of the intestines that affect approximately 1.4 million Americans, with that number evenly split between the two conditions (Crohn's and Colitis Foundation of America [CCFA], 2010).Symptoms of UC and CD can be quite debilitating, most commonly including diarrhea (which can be bloody) and abdominal pain.Typically, symptoms are chronic and characterized by periods of remission interrupted by exacerbations.Effective medical therapy for induction and maintenance of remission exists for both UC and CD; however, the relatively young age at diagnosis, potential for medication side effects, and the long-term need for medication to maintain remission can result in decreased adherence, which places patients at risk for exacerbations of disease (Kane et al., 2003).Also, patient miscomprehension can lead to decreased medication adherence (Sewitch, et al., 2003) and delays in seeking medical care with associated adverse outcomes.Several studies have evaluated the use of telemedicine in the IBD population.One pilot study assessed the acceptance of a home telemanagement system (HAT) in ten patients with IBD (Cross et al., 2006).This study utilized a HAT system developed for patients with asthma and other chronic respiratory diseases (Finkelstein et al, 2001 as cited in Cross et al, 2006).IBD HAT is comprised of three components: a patient home unit, a decision support server, and a web-based clinician portal as depicted in Figure 1.
Source: InTech eBooks
DOI: 10.5772/18860
Authors: Raymond Cross, Sandra
Institution: VA Maryland Health Care System
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W1560352669