P0254 Cost of telemonitoring with the App TECCU in Inflammatory Bowel Disease compared to standard care in Spain: a multicenter clinical trial of GETECCU
Authors: Aguas Peris M , Del Hoyo Francisco J , Vicente R , Barreiro-de Acosta M , Madero L , Hernández-Camba A , Melcarne L , Mesonero F , Arroyo M T , Sicilia B , Mañosa M , Martín-Arranz M D , Pajares R , Chaparro M , Martínez P , Chacón S , Tosca J , Calvo M , Marín S , Sanromán L , Zabana Y , Sainz E , Monfort D , Guerra I , Varela P , Baydal V , Corsino P , Porto-Silva S , Gutiérrez A , González M , Brunet E , Faubel R , Nos P 
Published: January 2025

Abstract

Background
Data of telemonitoring costs in inflammatory bowel disease (IBD) are scarce and restricted to a few centres. We evaluated healthcare and indirect costs of telemonitoring of IBD compared to standard care after 52 weeks on a nationwide scale.

Methods
A 2-arm randomized multicenter study was performed in 24 Spanish centers. We included adult patients with IBD who initiated therapy with immunosuppressant or biological agents. Patients with ileorectal/ileo-pouch anal anastomosis, stoma, active perianal disease or no Internet access were excluded. The follow-up in the telemonitoring group (G_TECCU) was based on the use of the TECCU app, while in the control group (G_control) it was based on in-person visits and telephone calls as per usual practice. We compared the number and cost of remote and in-person visits, as well as the cost of the patient trips to the medical center including the distance, time lost from work and monetary expenses1. Continuous variables are presented as mean and standard deviation (SD) and qualitative variables as absolute and relative frequency (%).

Results
We included 159 patients, and 126 of them completed the 52-week follow-up. The demographic and clinical variables are listed in Table 1. The mean of contacts per patient (in-person + remote) was 6.9 (1.9) in G_TECCU and 7.0 (1.9) in G_control (p=0.741). TECCU shifted in-person visits (3.1 (0.8) in G_TECCU vs 4.8 (1.5) in G_control, p=0.001) to remote contacts (3.7 (1.5) in G_TECCU vs 2.3 (1.0) in G_control, p=0.001). Non-scheduled visits were done in 63 (10.9%) patients (0.8 visits/patient) in G_TECCU compared to 50 (7.8%) patients (0.6 visits/patient) in G_control (p=0.538). These differences (Table 2) resulted in mean direct expenses of 130.6 (34.8) vs 225.3 (61.0) euros in G_TECCU vs G_control (p=0.001), being 124.3 (33.9) vs 192.5 (58.1) euros/patient for in-person visits (p=0.001) and 6.3 (2.5) vs 34.1 (15.6) euros/patient for remote contacts (p=0.001). The mean patient round-trip expenses for visits were 17.25 (27.3) euros in G_TECCU and 38.80 (47.2) euros in G_control (p=0.001). Patients from G_TECCU made a mean of 69.04 (121.3) Km and they lost a mean of 38.65 (37.7) % of their working hours during in-person visits, compared to 175.40 (217.9) Km and a mean of 45.48 (39.1)% of their working hours in G_control (p (Km)=0.001, and p (work)=0.265). According to the number of visits performed and their costs, each patient in G_TECCU saved 52.27 (79.3) Km of distance, 12.56 (8.2) hours in time out of work and 12.63 (15.9) euros in round-trip journeys.

Conclusion
Telemonitoring through the TECCU app reduces the number of in-person visits, the time out of work and monetary expenses of travelling to the medical center.

References
1.Del Hoyo J, Nos P, Bastida G, Faubel R, Muñoz D, Garrido-Marín A, Valero-Pérez E, Bejar-Serrano S, Aguas M. Telemonitoring of Crohn's Disease and Ulcerative Colitis (TECCU): Cost-Effectiveness Analysis. J Med Internet Res. 2019 Sep 13;21(9):e15505. doi: 10.2196/15505.