Your browser doesn't support javascript.
The effects of COVID-19 on IBD prescribing and service provision in a UK tertiary centre.
Sharma, Esha; Meade, Susanna; D'Errico, Francesca; Pavlidis, Polychronis; Luber, Raphael; Zeki, Sebastian; Hill, Katie; Duff, Alexa; O'Hanlon, Dearbhaile; Tripoli, Sherill; Stanton, Anna; Caracostea, Andra; Honap, Sailish; Reynolds, Rebecca; Anderson, Simon; Ray, Shuvra; Mawdsley, Joel; Sanderson, Jeremy; Samaan, Mark A; Irving, Peter M.
  • Sharma E; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Meade S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • D'Errico F; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Pavlidis P; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Luber R; School of Immunology and Microbial Sciences King's College London London UK.
  • Zeki S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Hill K; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Duff A; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • O'Hanlon D; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Tripoli S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Stanton A; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Caracostea A; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Honap S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Reynolds R; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Anderson S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Ray S; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Mawdsley J; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Sanderson J; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Samaan MA; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
  • Irving PM; Inflammatory Bowel Disease Unit Guy's and St Thomas' Hospital London UK.
GastroHep ; 2(6): 318-326, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-963136
ABSTRACT

BACKGROUND:

To quantify the effects of COVID-19 on our inflammatory bowel disease (IBD) unit, including service provision, prescribing practices and use of therapeutic drug monitoring (TDM).

METHODS:

We performed a single centre retrospective observational cohort study. Data was extracted from our IBD database, electronic patient records and radiology/endoscopy reporting systems between 16/3/20-17/4/20 and the corresponding period in 2019.

RESULTS:

A similar number of patients commenced biologic therapy before COVID-19 (n = 37) and during the pandemic (n = 36). Patients in the pre-COVID-19 cohort were older (median 36 vs 29 years, P = 0.009) with a longer median disease duration (9.3 vs 5.2 years, P = 0.02). During COVID-19 there was a nonsignificant increase in prescribing of vedolizumab (8/37, 22% vs 14/36, 39%, P = 0.13) and a higher proportion of patients were anti-TNF-naïve (3/17, 18% vs 18/24, 74%, P = 0.0004). There was a reduction in use of concomitant immunomodulators (22/29, 76% vs 4/34, 12%, P < 0.0001) and increased biologic use in thiopurine-naïve patients (3/37, 8% vs 15/36, 42%, P = 0.001). Use of TDM fell by 75% (240 vs 59 tests). Outpatient appointments fell by 68% and were conducted via telemedicine. MRI scanning, endoscopy, luminal surgery and inpatient numbers fell by 87%, 85%, 100% and 82% respectively. IBD Clinical Nurse Specialist and Pharmacist helpline contacts increased by 76% and 228% respectively.

CONCLUSIONS:

We observed prescribing differences during COVID-19, bypassing the initiation of immunomodulators and/or anti-TNF therapy in favour of vedolizumab with a reduction in immunomodulator prescribing. We also observed a rapid reorganisation of service provision, including a shift towards telemedicine and online solutions.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: GastroHep Year: 2020 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: GastroHep Year: 2020 Document Type: Article