Web-based interventions for ulcerative colitis and Crohn's disease: systematic review and future directions

Abstract

Behavioral intervention technologies (BITs), the application of psychological and behavioral interventions through the use of technology, provide the opportunity for clinicians to deliver care through a means that overcomes a number of treatment barriers. Web-based interventions are a subset of BITs developing as promising alternatives to face-to-face delivery of treatments and monitoring for patients with ulcerative colitis (UC) and Crohn's disease (CD). A systematic review of literature resulted in five empirical studies of web-based interventions for UC and CD. Additionally, an informal search of a popular search engine yielded limited, currently available, web-based interventions for patients with UC and CD. Despite being an ideal population for the development and dissemination of online interventions, patients with UC and CD have far less treatment options compared to other behavioral health concerns. However, given the growing body of research involving web-based interventions for other conditions, researchers and clinicians targeting UC and CD management and treatment have the benefit of being able to utilize the BIT model, an existing conceptual framework for the development of web-based interventions for both conditions. The BIT model is presented and applied to the treatment of UC and CD, as well as a technology development program, Purple, and usability guidelines to guide clinical researchers in the future development, evaluation, and dissemination of BITs for patients with UC and CD.

Keywords: BIT model; Crohn’s disease; IBD; behavioral intervention technologies; internet interventions; ulcerative colitis.

Figure 1

PRISMA flow diagram for systematic review of web-based interventions for ulcerative colitis and Crohn’s disease. Abbreviation: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Figure 2

BIT model framework applied to development of a BIT for treatment and monitoring of UC and CD. Abbreviations: BIT, behavioral intervention technology; UC, ulcerative colitis; CD, Crohn’s disease.

Figure 3

The BIT model and application to interventions for patients with ulcerative colitis (UC) and Crohn’s disease (CD). Abbreviation: BIT, behavioral intervention technology.