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
In brief
An IBD care pathway reduced hospital admissions but not emergency visits
In a Dutch study of 1,173 people with inflammatory bowel disease, implementing a structured care pathway was linked to fewer hospital admissions, with the reduction attributable to the pathway; the drop in emergency visits was not. Patient-reported disease control did not change, so the pathway's value appears to be in reducing admissions rather than improving symptoms.
- Journal
- BMJ open gastroenterology (Q1)
- Published
- 1 October 2026
- Study design
- Non-randomized / quasi-experimental trial
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Elyke H Visser, Martijn A Oude Voshaar, Reinier C A Van Linschoten, Jildou Hoekstra, Kristin Robbers, Vincent de Jonge, et al.
- PMID
- 42823103
- DOI
- 10.1136/bmjgast-2026-002381
Why clinicians should know about it
- Picked for Gastroenterology (paper of the day, 4 October 2026): Quasi-experimental IBD care pathway outcomes
Abstract
OBJECTIVE: Care pathways have the potential to decrease treatment variation and improve patient outcomes. This study aims to evaluate the effect of an advanced therapy care pathway (ACP) on patient outcomes, healthcare utilisation and treatment variation among patients with inflammatory bowel disease (IBD) in the Netherlands. METHODS: A multicentre, prospective quasi-experimental preimplementation/postimplementation study was conducted, with a preimplementation (December 2020-December 2021) and postimplementation period (March 2022-March 2023). Outcomes were collected from electronic medical records and validated questionnaires according to the International Consortium for Health Outcomes Measurement standard set. The effect of the ACP was analysed using difference-in-differences (DiD) analysis. RESULTS: 1173 patients were included; the majority was female (55%) with a median age of 45 years (IQR 33-58 years). Most patients had Crohn's disease (64%). Patients reported a high level of disease control and this did not change postimplementation (DiD-estimate: 0.12, 95% CI -0.74 to 1.01). Number of emergency room visits and hospital admissions decreased significantly 6 months postimplementation; however, the effect attributable to the ACP was only maintained for admissions (DiD-estimate visits: -0.05, 95% CI -0.10 to 0.01; DiD-estimate admissions: -0.06, 95% CI -0.11 to -0.03). CONCLUSION: Implementation of an ACP, in which a minimum of care is defined, can achieve outcomes comparable to standard practice, highlighting the value of prioritising structured care pathways, especially given the current burden of IBD on healthcare systems. An ACP can guide healthcare providers and policymakers in standardising treatment and improving quality of care in chronic disease management. STUDY REGISTRATION: NL8276/NL-OMON21751 (https://onderzoekmetmensen.nl/en/trial/21751).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.