Hau Liu, MD, MBA, MPH, MS1, Meghan M. Colosimo, MS, PhD1, Alex Bullock, 2, Keri Kalmbach, MS, PhD3, Dena M. Bravata, MD, MS4, Mark Pimentel, MD, FACG5 1Vivante Health, Chicago, IL; 2Vivante Health, Ann Arbor, MI; 3Vivante Health, San Francisco, CA; 4Stanford University, San Francisco, CA; 5Cedars-Sinai Medical Center, West Hollywood, CA
Introduction: Chronic gastrointestinal (GI) conditions are diverse and result in a wide range of digestive symptoms. We hypothesized that a digital digestive chronic care program that included longitudinal symptom tracking, personalized medical nutrition therapy, health coaching, and targeted education via a web-based app can lead to improvements in digestive symptoms.
Methods: Participants were eligible for a digital digestive chronic care program through their employment benefits. Upon enrollment, participants answered questions about their history and symptoms via a web-based app. A digestive symptom score was calculated (score range, 0-36) based on symptom severity (5 point scale: 0 no discomfort, 4 very severe discomfort) in nine digestive symptom domains (e.g., abdominal pain, constipation, diarrhea, bloating, reflux). Participants logged their digestive symptoms at baseline and during the course of their care, including during month 3, via the app to track clinical progress and guide subsequent interventions. Change in score was assessed at enrollment and month 3.
Results: A group of 659 ethnically and socially diverse participants provided symptom data (avg age: 43 years, 78% female, avg BMI 28, 36% Non-White). Of these, 89% reported symptom improvement at baseline and month 3, with an average decrease in symptom score of 64% (baseline avg; 7.6; month 3 avg: 2.7, p< 0.0001). Ninety-one percent of participants who were scheduled with a dietitian or health coach reported symptom improvement compared to 78% of those who were not scheduled with these providers (p< 0.001). Among participants who reported moderate or higher discomfort in at least one symptom domain (domain score of ≥2) at baseline, 93% reported symptom improvement with an average decrease in symptom score of 66% (n=538, baseline avg 8.7; month 3 avg 3.0, p< 0.0001). Using the average of multiple symptom scores in the last month of evaluation vs. the last symptom score was associated with higher rates of symptom improvement (93% vs 89%, p=0.04).
Discussion: Participants enrolled in a digital digestive chronic care program showed significant reduction in digestive symptom severity at 3 months compared to baseline. Care that incorporated GI dietitians and health coaches was associated with higher rates of symptom reduction. Use of a digital app to collect digestive symptom data holds promise for tracking a member’s clinical course. Further research is needed to determine the optimal digital symptom tracking process.
Disclosures:
Hau Liu: Teladoc Health – Employee, Stock Options, Stock-publicly held company(excluding mutual/index funds). Vivante Health – Employee, Stock Options.
Meghan Colosimo: Vivante Health – Employee.
Alex Bullock: Blue Cross Blue Shield Association – Consultant. Humana – Consultant. Vivante Health – Employee.
Keri Kalmbach: Vivante Health – Employee.
Dena Bravata: Vivante Health – Consultant.
Mark Pimentel: 9meters – Grant/Research Support, Cedars-Sinai has a licensing agreement with 9meters, Stock Options. Aytu Biosciences – Cedars-Sinai has a licensing agreement with Aytu Biosciences. Bausch Health – Grant/Research Support, Former consultant. Dieta Health – Consultant, Stock Options. Ferring Pharmaceuticals Inc – Consultant. Gemelli Biotech – Cedars-Sinai has a licensing agreement with Gemelli Biotech, Stock Options. Hobbs Medical – Cedars-Sinai has a licensing agreement with Hobbs Medical. Salvo Health – Consultant, Stock Options. Synthetic Biologics (now Theriva) – Grant/Research Support, Stock Options. Vivante Health Inc. – Consultant, Stock Options.
Hau Liu, MD, MBA, MPH, MS1, Meghan M. Colosimo, MS, PhD1, Alex Bullock, 2, Keri Kalmbach, MS, PhD3, Dena M. Bravata, MD, MS4, Mark Pimentel, MD, FACG5. P1236 - Improvements in Digestive Symptoms After Participation in a Digital Digestive Chronic Care Program, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
