React, reset and restore: Adaptation of a large inflammatory bowel disease service during COVID-19 pandemic

Gonzalez, Haidee Aleman; Myers, Sally; Whitehead, Emma; Pattinson, Alisson; Stamp, Katie; Turnbull, Jack; Fory, Rebecca; Featherstone, Bethia; Wilkinson, A R; Lisle, Jessica; Haire, Greg; Henderson, Eileen; Sebastia, Shaji

doi:10.7861/clinmed.2020-0369

Cited by 3 publications

(4 citation statements)

References 18 publications

(16 reference statements)

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“…In IBD, significantly improved medication adherence and reductions in outpatient visits and hospitalisations were reported with telemedicine versus standard care prior to the pandemic [ 110 , 111 ]. During the pandemic, a UK survey reported that telephone consultations replaced 86% of face-to-face clinics for patients with IBD [ 112 ]; in one unit, 92% of patients who had a consultation via telephone rather than in person were satisfied with their experience [ 102 ]. Gastroenterologists have also reported patient preferences for virtual management approaches during the pandemic and have described the value of SC biologics, including CT-P13 SC, in delivering home care-based management [ 71 ].…”

Section: Clinical Implications Of Sc Infliximab In the Covid-19 Pandemic Era And Beyondmentioning

confidence: 99%

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Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

et al. 2022

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Graphical Abstract The coronavirus disease 2019 (COVID-19) pandemic has prompted significant changes in patient care in rheumatology and gastroenterology, with clinical guidance issued to manage ongoing therapy while minimising the risk of nosocomial infection for patients and healthcare professionals (HCPs). Subcutaneous (SC) formulations of biologics enable patients to self-administer treatments at home; however, switching between agents may be undesirable. CT-P13 SC is the first SC formulation of infliximab that received regulatory approval and may be termed a biobetter as it offers significant clinical advantages over intravenous (IV) infliximab, including improved pharmacokinetics and a convenient mode of delivery. Potential benefits in terms of reduced immunogenicity have also been suggested. With a new SC formulation, infliximab provides an additional option for dual formulation, which enables patients to transition from IV to SC administration route without changing agent. Before COVID-19, clinical trials supported the efficacy and safety of switching from IV to SC infliximab for patients with rheumatoid arthritis and inflammatory bowel disease (IBD), and SC infliximab may have been selected on the basis of patient and HCP preferences for SC agents. During the pandemic, patients with rheumatic diseases and IBD have successfully switched from IV to SC infliximab, with some clinical benefits and high levels of patient satisfaction. As patients switched to SC therapeutics, the reduction in resource requirements for IV infusion services may have been particularly welcome given the pandemic, facilitating reorganisation and redeployment in overstretched healthcare systems, alongside pharmacoeconomic benefits and a reduction in exposure to nosocomial infection. Telemedicine and contactless healthcare have been pushed to the forefront during the pandemic, and a lasting shift towards remote patient management and community/home-based drug administration is anticipated. SC infliximab supports the implementation of this paradigm for future improvements of healthcare value delivered. The accumulation of real-world data during the pandemic supports the high level of confidence, with patients, physicians, and healthcare systems benefitting from its uptake.

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Section: Clinical Implications Of Sc Infliximab In the Covid-19 Pandemic Era And Beyondmentioning

confidence: 99%

“…Telemedicine and contactless healthcare are expected to continue to grow post-pandemic as key concepts of future healthcare systems (Table 1 ) [ 2 , 69 , 99 – 102 ]. Indeed, acceptance of digital tools increased during the pandemic [ 105 ].…”

Section: Clinical Implications Of Sc Infliximab In the Covid-19 Pandemic Era And Beyondmentioning

confidence: 99%

Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

et al. 2022

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“…Several recent publications have described the restrictions imposed by COVID-19 alongside prioritization and newer models of care in A&I and other medical and surgical specialties. [5][6][7][8][9] Specifically, the British Society for Allergy and Clinical Immunology (BSACI), the European Academy of Allergy and Clinical Immunology, and the American Academy of Allergy, Asthma & Immunology issued expert/consensus guidance regarding safe and strategic delivery of specialist A&I services during the pandemic. [10][11][12] We sought to assess the impact of COVID-19 pandemic on A&I services within secondary health care NHS facilities in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 Pandemic on Adult and Pediatric Allergy & Immunology Services in the UK National Health Service

Krishna

Beck

Gribbin

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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Background The COVID-19 pandemic imposed multiple restrictions on healthcare services. Objective To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the UK. Methods National survey of all A&I services registered with the Royal College of Physicians and/or British Society for Allergy and Clinical Immunology. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments and research activity. Weeks commencing 03 Feb’20 (pre-COVID), 06 April’20 and 08’May’20 were used as reference points for the dataset. Results 99 services participated. There was a reduction in nursing, medical, administrative and allied health professional staff during pandemic; 86% and 92% of A&I services continued to accept non-urgent and urgent referrals respectively during the pandemic. There were changes in immunoglobulin (Ig) dose and infusion regimen in 67% and 14% of adult and pediatric services respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, p≤0.0001) reduction in the following: face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing and hospital procedures (food challenges, immunoglobulin and omalizumab, administration); and a significant increase (p≤0.0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious. Conclusion The pandemic had significant impact on A&I services leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long term to achieve equitable, safe and standardised healthcare.

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“…The urgent requirement for non-invasive indices in IBD is additionally augmented by the recent global growth in IBD incidence rates [24]. Furthermore, the current COVID-19 pandemic highlighted the significance of non-invasive point-of-care tests, that may be integrated with telemedicine in IBD patient care [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Faecal Calprotectin in Assessment of Mucosal Healing in Adults with Inflammatory Bowel Disease: A Meta-Analysis

Bromke

Neubauer

Kempiński

et al. 2021

JCM

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Achieving mucosal healing in patients with inflammatory bowel disease is related to a higher incidence of sustained clinical remission and it translates to lower rates of hospitalisation and surgery. The assessment methods of disease activity and response to therapy are limited and mainly rely on colonoscopy. This meta-analysis reviews the effectiveness of using faecal calprotectin as a marker for mucosal healing in inflammatory bowel disease. Two meta-analyses were conducted in parallel. The analysis on the use of faecal calprotectin in monitoring mucosal healing in colonic Crohn’s disease is based on 16 publications (17 studies). The data set for diagnostic values of faecal calprotectin in ulcerative colitis is composed of 35 original publications (total 49 studies). The DOR for the use of faecal calprotectin in Crohn’s disease is estimated to be 11.20 and the area under the sROCis 0.829. In cases of ulcerative colitis, the DOR is 14.48, while the AUC sROC is 0.858. Heterogeneity of the studies was moderatetosubstantial. Collected data show overall good sensitivity and specificity of the faecal calprotectin test, as well as a good DOR. Thus, monitoring of mucosal healing with a non-invasive faecal calprotectin test may represent an attractive option for physicians and patients with inflammatory bowel disease.

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React, reset and restore: Adaptation of a large inflammatory bowel disease service during COVID-19 pandemic

Cited by 3 publications

References 18 publications

Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

The Impact of COVID-19 Pandemic on Adult and Pediatric Allergy & Immunology Services in the UK National Health Service

Faecal Calprotectin in Assessment of Mucosal Healing in Adults with Inflammatory Bowel Disease: A Meta-Analysis

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