Rational Monitoring of Patients With Inflammatory Bowel Disease in Remission: Results From the Danish DK‐MONITOR Delphi Consensus Study

Background Monitoring strategies for patients with inflammatory bowel disease (IBD) in remission vary widely in clinical practice, reflecting limited evidence and a lack of consensus. With increasing numbers of patients living long term with IBD, there is a need for rational, clinically meaningful approaches to remission‐phase monitoring. Methods DK‐MONITOR was conducted as a national, multidisciplinary Delphi consensus study in Denmark during 2025–2026. Gastroenterologists and IBD nurses from centres providing specialist IBD care developed and voted on draft statements addressing the monitoring of Crohn's disease and ulcerative colitis in whom objective remission had previously been confirmed. Statements were evaluated using anonymous electronic voting, with consensus predefined as ≥ 70% agreement. All statements were discussed at a face‐to‐face national consensus meeting, and statements not achieving consensus were revised and re‐voted. Results A total of 28 gastroenterologists and 19 IBD nurses participated. Fifty draft statements were evaluated in the first voting round; 25 were subjected to a second voting round, and 22 achieved final consensus. The consensus supports monitoring strategies based primarily on patient‐reported outcomes and biomarkers, with selective use of endoscopy, imaging and therapeutic drug monitoring. Routine use of invasive investigations in stable patients was generally discouraged. A structured, conservative monitoring approach was agreed for patients with mild Crohn's disease managed without maintenance therapy. No consensus was reached for monitoring strategies in ulcerative colitis treated solely with 5‐aminosalicylates. Conclusion DK‐MONITOR provides a pragmatic, clinician‐oriented framework for monitoring patients with IBD in remission, emphasising biomarker‐based assessment, individualised follow‐up and avoidance of unnecessary investigations. Adaptation may be required before implementation in other healthcare settings.