A Qualitative Study on Shared Decision Making in the Choice to Use Telemonitoring in the Management of Inflammatory Bowel Disease

Introduction: Telemedicine has shown to play a promising role in enhancing patient care. Moreover, it is a key component of the Integraal Zorgakkoord (IZA), facilitating more efficient and accessible healthcare through telemonitoring and digital health innovations. However, it remains uncertain how Shared Decision Making (SDM) plays a role in the choice of telemedicine. Research focuses on technological capabilities or general patient-centredness, rather than how to effectively integrate SDM into decisions about using telemonitoring versus standard care. The integration of SDM into telemonitoring remains fragmented, suggesting that current SDM frameworks have not been adapted to the shift to telemedicine. If SDM is not achieved in this decision a decrease of adherence and engagement may follow.

Research question: The aim of this qualitative study is to get a better understanding of role of SDM in the choice of telemonitoring or standard care. These insights could help to offer improvements to SDM in IBD care to patients. This led to the following research questions:

1. How to optimize the decision-making process for patients with inflammatory bowel disease in the decision for telemonitoring? 1.1 How do patients and healthcare professionals perceive the current SDM within care processes for IBD?

Study design: This is a qualitative study using semi-structured interviews. Information about patient's and professionals' experiences and preferences about SDM will be collected. To guide the topics in the interview, two theories/models will be used:

1. The Three-Talk Model
2. AAMC Telehealth Competencies Data will be analysed using thematic analysis.

Study population: Consecutive adult (≥18 years) IBD patients and IBD healthcare professionals at Jeroen Bosch Hospital and Franciscus who have experienced making a choice about telemonitoring will be asked if they are willing to participate. Next, a total of 16 respondents will be include 10 patients and 6 healthcare professionals. Both patients using telemonitoring and patients who are not interested will be included. Should data saturation not have occurred, more respondents will be included.

Expected results and relevance: The objective is to investigates if and how SDM is currently integrated into the telemonitoring processes for IBD patients. The goal is to use these insights to strengthen SDM in the decision for telemonitoring for IBD patients.