Advanced Therapy Care Pathway Maintains IBD Outcomes

An advanced therapy care pathway (ACP) maintained outcomes for patients with inflammatory bowel disease (IBD) while reducing hospital admissions, according to a multicentre, prospective study in the Netherlands.

Study Design and Population

Researchers evaluated an ACP designed to reduce treatment variation and support consistent care for patients with IBD. The multicentre, prospective, quasi-experimental study compared outcomes before and after implementation of the pathway.

The preimplementation period ran from December 2020–December 2021, while the postimplementation period ran from March 2022–March 2023. Outcomes were collected from electronic medical records and validated questionnaires based on the International Consortium for Health Outcomes Measurement standard set. The effect of the ACP was assessed using difference-in-differences analysis.

A total of 1,173 patients were included. Most participants were female, accounting for 55%, and the median age was 45 years, with an interquartile range of 33–58 years. Crohn’s disease was the most common form of IBD, affecting 64% of participants.

Advanced Therapy Care Pathway and Outcomes

Patients reported a high level of disease control before implementation, and this remained stable afterwards. The change attributable to the ACP was not significant (difference-in-differences estimate: 0.12; 95% CI: −0.74–1.01).

Emergency room visits and hospital admissions both decreased significantly 6 months after implementation. However, the reduction in emergency room visits was not maintained when the effect specifically attributable to the ACP was assessed (difference-in-differences estimate: −0.05; 95% CI: −0.10–0.01).

The reduction in hospital admissions remained associated with implementation of the pathway (difference-in-differences estimate: −0.06; 95% CI: −0.11–−0.03).

Implications for IBD Care

The findings indicated that an ACP defining a minimum standard of care achieved outcomes comparable with standard practice. The researchers suggested that structured pathways could provide a framework for supporting consistent care without compromising reported disease control.

For healthcare providers and policymakers, the findings highlighted the potential value of standardising elements of chronic disease management. The authors concluded that an ACP could help guide treatment and improve quality of care, particularly given the healthcare burden associated with IBD.

The study therefore supported the use of structured care pathways as a means of maintaining patient outcomes while potentially reducing healthcare utilisation, particularly hospital admissions.

Reference

Visser EH et al. Patient outcomes and healthcare utilisation following implementation of an advanced therapy care pathway for inflammatory bowel disease: a multicentre, prospective quasi-experimental preimplementation/postimplementation study in the Netherlands. BMJ Open Gastroenterol. 2026;13(1):e002381.