TOPLINE:

A novel clinical care pathway for managing flares in inflammatory bowel disease (IBD) — featuring nurse-led triage and rapid-access intestinal ultrasound (RAIUS) — reduced hospital resource use and emergency department visits, improved patient satisfaction, and generated substantial cost savings. 

METHODOLOGY:

• Patients with IBD flares experience debilitating symptoms that impair quality of life and productivity, and untreated inflammation causes progressive bowel damage and increased healthcare utilization.
• Between November 2022 and June 2023, researchers in Australia enrolled patients with IBD to assess the impact of a novel early flare clinical care pathway.
• Patients were triaged by IBD nurses using a symptom severity-based protocol, followed by specialist discussion, referral for RAIUS, or hospital admission planning based on clinical urgency.
• Study objectives were to characterize outcomes after pathway implementation (eg, patient satisfaction surveys), assess its impact on hospital resource utilization, and evaluate its cost-effectiveness.

TAKEAWAY:

• Of documented episodes of care in 211 patients (median age, 34 years; 66% female), 78% were classified as flares and RAIUS was used in 27%.
• Compared with the same months in the prior year, the postimplementation period saw significant reductions in emergency department visits (14 vs 44) and hospital admissions (10 vs 38).
• Unplanned hospital visits were avoided in 9.5% of cases, hospital resource utilization was unchanged in 32.2%, and early clinic reviews were avoided in 58.3%, yielding an estimated net savings of AUD $146,417.99 over 30 weeks.
• Patient satisfaction with the IBD service increased after pathway implementation, with more patients reporting being satisfied or very satisfied.

IN PRACTICE:

“A pathway focusing on timely response can facilitate early management to reduce the impact of IBD flares, and the utilization of point-of-care disease activity assessment using [intestinal ultrasound] can enable accurate distinction between inflammatory and noninflammatory symptoms to support judicious and appropriate medication use,” the authors wrote. 

SOURCE:

This study was led by Richard Gareth Fernandes, MD, Mater Hospital Brisbane, Brisbane, Australia. It was published online in the Journal of Crohn’s and Colitis.

LIMITATIONS:

The study was limited by its single-center design. Use of a retrospective comparator for emergency department visits and admissions introduced some uncertainty. The survey nonresponse rate was high (71.6%).

DISCLOSURES:

The study did not receive any funding. Several authors reported serving in advisory board roles or receiving grants, research funding, educational support, or honoraria from various institutions and pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.