Tuesday, February 21, 2012

Telehealth to Help IBD Patients

Research on medication adherence in pediatric Inflammatory Bowel Disease (IBD) has demonstrated that pediatric patients do not adhere to their medication regime from rates that range from 50 to 88 percent of the time.

This data is alarming since the risk of relapse in IBD is 5.5 times more for patients that do not take their medications properly than for those patients that adhere to the medication schedule. In addition, the annual costs of healthcare for IBD patients that do not adhere to their medication schedule are 12.5 percent higher and cost the U.S. healthcare system $100 to $300 billion more.

Factors that relate to the problem are lack of knowledge about IBD, the medications that can be used for treatment, organizational barriers, and not addressing the behavioral problems found in adolescents and sometimes their families.

Current studies demonstrate the feasibility of providing family-based behavioral intervention which is viewed favorably by patients and families and results in higher medication adherence. Individually tailored behavioral treatments are advantageous because of the ability to analyze and target specific behaviors that are preventing adherence to medications.

However, only a limited subgroup of patients are able to receive this type of treatment due to a lack of available trained providers and in addition, the long distances between patients and their treatment facility can make it difficult for patients to attend the necessary weekly treatment sessions.

The current study in this field is being funded by the National Institute of Child Health and Human Development (NICHD) and is taking place at the Cincinnati Children’s Hospital Medical Center. The Medical Center is working with 194 patients (11-18) and their families via a randomized controlled clinical trial.

The study is examining how telehealth can be used to provide behavioral treatment to improve medication adherence but also studying how to improve the quality of life for children with IBD. The study is also targeting a clinically relevant sample of patients who demonstrate substantial resistant to taking their medications and how it may be affecting their health outcomes.

The study may impact public health by providing an evidence base that shows how an individually tailored behavioral treatment to support taking medications may reduce healthcare disparities for families that have limited access to services.

The grant study “Telehealth Enchancement of Adherence to Medication in Pediatric IBD” (R01HD06717-01A1) was initiated in 2011 with the final year to be 2016.

For more information, email Kevin Hommel at the Division of Behavioral Medicine and Clinical Psychology at the Cincinnati Children’s Hospital Medical at Kevin.hommel@cchmc.org or call (513) 803-0407.