Why is it important?
Being admitted to hospital with Crohn’s Disease or Ulcerative Colitis can be a very worrying time.
This anxiety can be reduced when patients, carers and families feel able to raise issues or concerns that are important to them. But that’s hard when multiple teams and clinicians are involved in care and decision-making processes during an inpatient admission. This complexity can make communication difficult.
That’s why having access to an IBD Nurse Specialist is so important at this time. It can help give patients better continuity of care and improved coordination, as well as education and support for them and their families/carers.
In fact, evidence suggests that the IBD Nurse position reduces hospital admissions for flares, as well as the number of days IBD patients spend in hospital.1 They also facilitate faster access to education provision, allowing patients to feel more supported, with a clear understanding about what will happen next during the transition between inpatient and outpatient care.2 Unfortunately, only 40% of adult patients partaking in the IBD UK Benchmarking reported seeing a specialist IBD nurse during admission, representing a significant gap in specialist nursing provision.
Another essential part of high-quality inpatient care is medicines management.
Through medication reviews, we can critically evaluate a patient’s medications and help optimise therapy and reduce the risk of adverse drug events. This can help avoid prolonged hospital stays, higher mortality rates and increased costs.
Given the complexity of drug therapies in use for IBD, it is important that an expert pharmacist in IBD is available for advice during the inpatient stay and at discharge.
Patients need to be involved in decisions about their care, as much as they feel able. Good medicine management before discharge happens when patients get the appropriate level of (written and verbal) information and counselling. This should include information on the medicine itself, how it should be taken and any changes. It should be offered in a variety of formats – written, audio-visual and web-based – and in language that the patient can understand.
Pharmaceutical discharge planning should start at admission by the ward pharmacy team, under the supervision of the expert pharmacist in IBD. Any changes should be communicated to the GP and the patient’s IBD team.