A qualitative study on how patients with inflammatory bowel disease feel supported in managing their disease using an app

BACKGROUND
Inflammatory Bowel Disease (IBD) is incurable and, for most patients, lifelong treatment and regular follow-up is required. A close communication with healthcare professionals is crucial. Recent studies show that E- health technologies are promising tools for close monitoring and communication among patients with IBD. Especially mobile-health apps are becoming increasingly popular. Based on need assessment and user involvement, an IBD-app was developed to support patients’ communication with healthcare professionals. The aim of this study was to explore patients’ experiences on how they feel supported in managing their disease using this IBD-app.

METHODS
A phenomenological hermeneutic approach based on qualitative methods was applied to obtain an understanding of the patients’ experiences on how they feel supported in managing their disease using an app. Individual telephone interviews with 12 outpatients were conducted. Participants were recruited from two outpatient clinics at the Departments of Medical Gastroenterology at Odense University Hospital and Hospital South West Jutland in Esbjerg. The analysis was based on condensation of meaning. The tool consists of five steps that allows the researcher to give, the opinions expressed by the informant, a shorter formulation. It summarizes long statements and record the main meaning in few words. Afterwards, the informants' statements are exposed to a critical commonsense and theoretical interpretation with the aim of a broader understanding.

RESULTS
Twelve outpatients with IBD, including five men and seven women age range from 18-75, participated in individual telephone interviews. The analysis generated four themes on how they feel supported in managing their disease through an app. The patients feel supported when the app helps them to: (1) strength selfcare-management through empowerment (2) conserves autonomy through a flexible contact with healthcare professionals (3) obtain a care-relationship through access to healthcare professionals (4) obtain dialogue with healthcare professionals.

CONCLUSION
This study indicates that patients with IBD perceived an app developed to support patients’ communication with healthcare professionals as meaningful and supportive. The results suggest the usefulness of building in functionality to support empowerment, autonomy, care-relationships and dialogue. Further studies on efficacy and usability in a clinical setting, including health care providers, are needed.