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. You would think a negative result would be reassuring, but possibly the worry is that with a low result they will be told nothing is wrong even though they may be feeling unwell. 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 verses non-biologic treatments seemed happier knowing when to use the IBDoc and knowing how to manage their condition. This is probably fairly intuitive because to get to the stage of being on biologics they have had the disease a while and it hasn’t been very easy to manage and therefore they have had to be more engaged. Improvements Some of the things that were cited by the patients that would make things easier were: • More regular contact from the IBD team, especially when starting a new treatment • More information on what causes a flare and how to control them • Access to a nutritionist/dietary advice • Better communication between the primary and secondary care providers • Access available on a wider selection of phones Fundamentally the patients seem to like the actual 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 continuous addressed but there is inevitably a delay. The Future I think it is a genuine candidate 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 forwards, we just need to get the education aspect right. The IBDoc home testing works so well for a large number of our patients which means it can work well for most of them, we just have to get better at the support side so that patients are confident they understand the results and their condition and are beingmanaged appropriately. There is probably a lot we can learn from other chronic conditions that have been historically remotely managed like diabetes, which must also have to cope with different patient groups and different levels of engagement. Whilst this type of test will never be for everyone (let’s be honest there are some patients who will just never do a stool test regardless of where it is completed), for many this type of technology is appreciated. It has the potential to help patient engagement and support remote management and personalised care. “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 decisionmaking and patient management. It doesn’t really add more work because you save work in chasing results and additional support for patients whilst they arewaiting for results.” – Dr Pushpakaran Munuswamy Find out more at www.calprotectin.co.uk/ibdoc www.alphalabs.co.uk © 2023 Copyright Alpha Laboratories Ltd. 7
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