Shaping inflammatory bowel disease care through patient choice and joint decision-making

Abstract

Patient choice and shared decision-making are priorities in the treatment of inflammatory bowel disease (IBD). The choices facilitated by UK IBD services were affected by the COVID-19 pandemic from when it began to affect the UK in early 2020, with an almost overnight stoppage of face-to-face outpatient clinic appointments and a recognition that some IBD treatments, such as steroids, may have a negative impact on patient outcome. Many IBD services struggled with staff redeployment and growing demand from unwell and concerned patients. Subsequent changes in treatment pathways resulted in some patients accessing biologic therapies at earlier stages than previously. The need to involve patients in decisions regarding their care became more important than ever, due to the potential impact of the pandemic on their disease and treatment pathway. This impact interacted with other key factors affecting patient choice, such as the perceived and real-world costs of biologic and biosimilar treatments. This review looks at how COVID-19 affected patient choice and how IBD clinical nurse specialists can use the principles of joint decision-making to move forward in developing IBD services for the future. Declaration of interest This article was commissioned and funded by Takeda UK Ltd, who suggested the author and topic. Takeda UK Ltd also reviewed and approved the content. Prescribing information can be found at the end of the article.