Patient Perspectives to Inform Co-creation of Wearable-Derived Digital Biomarkers for Early Flare Detection and Management in IBD: A Survey-Based Study

Wearable-derived digital biomarkers represent a new frontier in remote management of inflammatory bowel disease (IBD). They may enable continuous disease surveillance and early flare detection while reducing reliance on questionnaire-based remote monitoring. However, successful implementation into clinical practice critically depends on patient acceptance and perceived relevance. To guide patient-centered digital health strategies, we aimed to investigate patient perspectives on digital biomarkers for (early) flare detection. A nationwide cross-sectional survey-based study was conducted among patients with IBD (≥ 16 years) in the Netherlands. A study-specific questionnaire was distributed through the Dutch patient organization Crohn & Colitis NL to assess acceptance, preferences, and perspectives on the use of wearable technology for flare detection. 1,080 participants were included: 72.5% women, 53.4% aged >50 years, and 28.7% current wearable users. Overall, 88% considered remote monitoring for flare detection potentially useful, and over 90% believed wearables could support this. Motivations for using wearables included flare detection, better understanding of symptoms, and health monitoring. User-friendliness, clear alerts, and time efficiency were key device preferences, and smartwatches were the preferred wearable device. Shorter disease duration ( p <0.001), more frequent flares ( p =0.029), younger age ( p =0.016), and current wearable use ( p <0.001) were identified as predictors for willingness to use wearables. Patients with IBD value wearables for flare detection and disease-monitoring. Most participants expressed willingness to use digital biomarkers and believed that wearables could support routine care. Incorporating patient preferences into digital biomarker development will likely improve patient acceptance and adherence to remote monitoring.