Telemonitoring in Inflammatory Bowel Disease: Findings from the TIGE-Rus Randomized Controlled Trial

Background: Telemedicine is increasingly used in inflammatory bowel disease (IBD), but its effects on quality of life (QoL) and psychological outcomes remain unclear. Objectives: This study aimed to evaluate the impact of 6-month telemonitoring on QoL, disease activity, treatment adherence, psychological well-being, patient satisfaction, and healthcare utilization. Methods: This randomized, open-label, single-center study conducted in Russia (July 2023-December 2024) included adults with ulcerative colitis or Crohn's disease, who were assigned 1:1 to telemonitoring or standard care. The intervention involved monthly remote assessments and access to a web-based platform containing educational information, disease activity assessment, and a chat with a gastroenterologist. The primary outcome was health-related QoL (SIBDQ). Exploratory outcomes included general QoL (WHOQOL-26), psychological well-being (HADS), alexithymia (TAS-26), visceral sensitivity (VSI), treatment adherence (GMAS), patient satisfaction (PSQ-18), achievement of clinical remission, and healthcare utilization. Results: Sixty-eight patients completed the study (32 intervention, 36 control). Telemonitoring was associated with lower anxiety levels (β = -1.76, p = 0.021), reduced visceral sensitivity (β = -5.08, p = 0.039), and higher medication adherence (β = 1.75, p = 0.008). No significant associations were observed for SIBDQ, WHOQOL-26 domains, depressive symptoms, alexithymia, achievement of clinical remission, or patient satisfaction with care (p > 0.05). Patients in the telemonitoring group also required fewer outpatient visits (p < 0.001), with no difference in hospitalizations. Within-group analysis demonstrated improvements in QoL, treatment adherence, visceral sensitivity, and disease activity in the telemonitoring group, but not in the controls. Conclusions: Six-month telemonitoring in IBD was associated with lower anxiety, reduced visceral sensitivity, improved treatment adherence, and fewer outpatient visits. The health-related QoL assessed by the SIBDQ did not differ compared to standard care. No clear clinical disadvantage compared with standard care was detected during the study period.