P339 Crohn’s disease and self-monitoring through a mobile App: The Medicrohn study

Mobile Applications represent a promising tool to facilitate self-management as a new model of health care delivery for IBD. The MediCrohn study was designed to evaluate the diagnostic performance of the Harvey–Bradshaw index (HBI) self-administered by Crohn disease (CD) patients through a Mobile App, compared with the original HBI questionnaire assessed by the gastroenterologist in the clinic (reference). The study was a multicentre, prospective study, including CD patients, aged 18+, with diagnosis for >6 months and familiar with new technologies who were followed-up during 4 months. Patients completed the HBI through a mobile app at months 1 and 4, and thereafter, it was completed in-clinic by physicians who was blinded for the patients’ responses. We assessed agreement between patient and physician HBI with the Cohen’s kappa, intraclass correlation coefficients (ICCs), and Bland–Altman plot. HBI < 5 was considered as inactive disease. We included 219 patients (mean age: 36 ± 8 years, 53% women). Percentage of global agreement between clinician and patient assessment, both evaluating CD as active or in remission was 92.4%. Only in 8% of the cases, the patient classified CD as active, whereas the physician evaluated it as inactive and the 94% of the patients on remission were classified correctly through the App. Correlation of the changes in CD activity from month 1 to month 4 was available for 166 pairs of questionnaires. According to patients’ evaluation, CD was considered stable in 93 cases (56%), whereas physicians categorised CD as stable in 99 cases ( 59.6%). Percentage of agreement in the change in disease activity from month 1 to month 4 was 72%. Self-administration of the HBI by patients with CD via a mobile app resulted in a high percentage of agreement with the in-clinic gastroenterologist evaluation, with high sensitivity, specificity and positive predictive value for assessment of disease activity. Results of the MediCrohn study encourage the use of this mobile app as a support for the involvement of patients in the management of their disease. Future studies will help to define its precise role in clinical practice.