Abstract Background Specialist pharmacists are well positioned to manage patients on oral advanced therapies for inflammatory bowel disease (IBD). At Oxford University Hospitals (OUH), the pharmacy team is responsible for prescribing the majority of advanced therapeutic treatments following multi-disciplinary (MDT) approval. With a growing patient population, maintaining reliable post-induction reviews to assess initial response to the medication has become increasingly challenging due to medical and nursing team capacity. A pharmacist-led small molecule clinic was introduced to alleviate pressure on medical and nursing staff and allow safe and timely prescription renewal by the pharmacy team. Objective To evaluate the implementation of a pharmacist-led small molecule clinic (SMC) for post-induction follow-up in patients with IBD, assessing its benefits to patient care, the multidisciplinary team (MDT), and the wider Trust. Methods A retrospective review of pharmacist-led post-induction clinics was conducted using pharmacy-managed databases. Clinic letters were reviewed for adverse effects, treatment outcomes, and escalation plans of patients who had been initiated on a JAKi or SP1 modulator. These appointments were conducted approximately 10 weeks after treatment initiation and booked by the pharmacy team. Some patients were concurrently followed up through Pharma-funded observational studies (EFFECT-UC, GALOCEAN, and PROFUNDUS). Results Of 165 eligible patients, 141 (85%) were reviewed in the SMC. Among these, 106 continued their current treatment regimen, 20 had extended induction courses, 4 required dose reductions, and 8 discontinued therapies due to insufficient response. Adverse effect reportingSC1, particularly for acne associated with upadacitinib (observed in over 30% of patients) and derangements in lipid biochemistry requiring statin therapy were actioned through the clinic. Conclusion The implementation of a pharmacist-led post-induction clinic has provided substantial benefits, including timely prescription renewals, improved adverse effect management, and enhanced multidisciplinary working. Ongoing challenges include improving follow-up for patients who miss appointments. Further service development is warranted to optimise capacity and consistency of care. Conflict of interest: Mr. Sanford, Jack: No conflict of interest Cripps, Sarah: Consultancy fees: Abbvie, Advanz, Dr Falk, Galapagos, Pfizer, Lilly, SALTs healthcare, Sandoz, Takeda Sponsorship: Abbvie, BMS, Celltrion, Gilead, Lilly, Tillots Azzu, Hanan: Paid speaker by Takada and Pfizer Perera, Laura: No conflict of interest
Sanford et al. (2026) studied this question.