Abstract Background The increasing prevalence of inflammatory bowel disease (IBD)1 and rapid expansion and access to new medical therapies have put unprecedented demand on IBD services. To help support our outpatient service and provide safe and timely care for patients, we established a specialist pharmacist-led clinic for IBD patients commencing a Janus kinase inhibitor (JAKi). Following the decision to commence upadacitinib or filgotinib, patients were referred to the new JAKi clinic where a specialist pharmacist provided counselling, initiated and monitored treatment, and guided transition to maintenance therapy. Methods We conducted a retrospective analysis of clinical records of patients with IBD commenced on upadacitinib or filgotinib at the Royal Free London NHS Foundation Trust, a tertiary referral IBD centre, between January 2023 and November 2025. This included the periods before and after the implementation of the specialist pharmacist-led JAKi clinic in November 2024. Results 67 patients were commenced on a JAKi within this time period, 25 (37.3%) were female. Mean age at initiation was 37.2 (SD 11.9). 37 (55.2%) patients had Crohn’s disease and 30 (44.8%) had ulcerative colitis. 48 (71.6%) were commenced on upadacitinib and 19 (28.4%) on filgotinib. 32 (47.8%) patients were initiated on treatment prior to, and 35 (52.2%) after, introduction of the pharmacist-led JAKi clinic (see Table 1). The pharmacist-led JAKi clinic reduced the mean time from the decision to start treatment to the commencement from 70.2 to 25.1 days. Miscommunication or misunderstanding causing treatment delays or gaps occurred in 18.8% (6/32) of patients prior to the clinic, but none after its introduction. Documentation of pre-initiation counselling improved from 84.4% (27/32) to 100% (35/35), including counselling on VTE, infections, shingles, acne, and cholesterol (see Table 1). Documented counselling regarding pregnancy prevention in patients with childbearing potential rose from 16.7% (2/12) to 100% (12/12). Adherence to monthly blood monitoring during induction increased from 46.9% (15/32) to 72.4% (21/29), and patients receiving post-induction reviews prior to transitioning to maintenance therapy improved from 56.3% (18/32) to 100% (13/13) Conclusion A specialist pharmacist-led JAKi clinic reduced the time to treatment initiation, eliminated communication-related delays, improved pre-initiation counselling, adherence to blood monitoring, and facilitated timely post-induction reviews. These findings demonstrate the value of pharmacist-led clinics in optimising patient care and improving patient safety within a busy tertiary IBD service. Reference: 1 Herauf M, Coward S, Peña-Sánchez JN, Bernstein CN, Benchimol EI, Kaplan GG, et al. Commentary on the Epidemiology of Inflammatory Bowel Disease in Compounding Prevalence Nations: Toward Sustaining Healthcare Delivery. Gastroenterology. 2024;166(6):949-956. doi:10.1053/j.gastro.2024.02.016 Conflict of interest: Dr. Chowdhury, Aqib: No conflict of interest Taherzadeh, Nina: Takeda - paid panel session for IBD study day Cheshire, Alex: No conflict of interest Erian, Gamal: No conflict of interest Woodfield, Georgia: No conflict of interest Cader, Mohammed Zaeem: No conflict of interest Lee, James: Grant: GSK Personal Fees: Abbie, C4X Discovery, PredictImmune, Falk Murray, Charles: No conflict of interest O’Shea, Nuala Roisin: No conflict of interest
Chowdhury et al. (Thu,) studied this question.