Diagnostics
“Having the result straight away, instead of weeks waiting, is really beneficial as you can start on the medication you require.” Other comments included: “I absolutely love it! I get upset when they send out a normal stool sample test and not the IBDoc.” “Using the test has increased the engagement
from both the patients and the clinical team, and the speed of the results makes a big impact in decision making and patient management,” commented Dr. Munuswamy. “It doesn’t add more work; in fact, you save work in chasing results and additional support for patients while they are waiting for results.”
Aftercare The survey showed that 94% of patients would feel satisfied with a phone consultation, rather than a face-to-face appointment, following a high result, compared to 43% who feel some level of dissatisfaction at receiving no clinical contact following a negative result. Patients know what the plan is if a high
result is obtained; they will get their medication increased or switched or have further investigations, so they are happier with a phone consultation. A low result means that the symptoms are
unlikely to be caused by their IBD and need to be managed in another way. This highlights that patients do not know what to do and would still need clinical advice or better educational materials explaining the potential causes and treatments of the symptoms if they aren’t caused by IBD. The patients on the biologics versus non-biologic treatments seemed happier knowing when to use the test and knowing how to manage their condition.
Improvements Some of the things that were cited by the patients that would make things easier were:
Using the IBDoc has increased the engagement from both the patients and the clinical team, and the speed of the results really makes a big impact in decision making and patient management. It doesn’t add more work; in fact, you save work in chasing results and additional support for patients
while they are waiting for results. Dr. Pushpakaran Munuswamy
Monitor treatment success Predicted early disease relapse Results reflected the clinical status
Good understanding of what the result meant for their disease state
70% Table 2. Patient survey results
l More regular contact from the IBD team, especially when starting a new treatment.
l More information on what causes a flare and how to control them.
l Access to a nutritionist/dietary advice. l Better communication between the primary and secondary care providers.
l Access available on a wider selection of phones.
Fundamentally, the patients seem to like the test. Most of the points raised relate to the educational and support functions that need to underpin the adoption of new technologies. The wider selection of phones is a continuously moving goalpost; as new phones are released they need to be validated for use to ensure accurate correlation to the laboratory results.
This is continuously addressed but there is inevitably a delay.
The future This form of testing has potential for patient self-management but we need to do more in educating patients and personalising the care that surrounds this. There are easier point of care tests than calprotectin testing, but the patients want it enough that they are prepared to do it and it works for them. Some have even changed phones so that they can use the system – this shows the level of engagement within the patient population and the desire to be able to access the new technology. Remote monitoring and patient self- management will be key to managing services going forward, but it is important to get the education aspect right. The IBDoc home testing works well for a
large number of patients. However, this needs to be combined with effective support, so that patients are confident they understand the results and their condition and are being managed appropriately. There is a great deal that we can learn
from other chronic conditions that have been remotely managed – such as diabetes – particularly around managing different patient groups and different levels of engagement. This type of test isn’t for everyone (there are some patients who will never do a stool test regardless of where it is completed), but for many, this type of technology is appreciated. It has the potential to help patient engagement and support remote management and the delivery of personalised care.
75% 80% 85% 90% 95%
CSJ March 2024 I
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