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?:abstract
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Background: To quantify the effects of COVID-19 on our inflammatory bowel disease (IBD) unit, including service provision, prescribing practices and use of therapeutic drug monitoring (TDM) Methods: We performed a single centre retrospective observational cohort study Data was extracted from our IBD database, electronic patient records and radiology/endoscopy reporting systems between 16/3/20-17/4/20 and the corresponding period in 2019 Results: A similar number of patients commenced biologic therapy before COVID-19 (n = 37) and during the pandemic (n = 36) Patients in the pre-COVID-19 cohort were older (median 36 vs 29 years, P = 0 009) with a longer median disease duration (9 3 vs 5 2 years, P = 0 02) During COVID-19 there was a nonsignificant increase in prescribing of vedolizumab (8/37, 22% vs 14/36, 39%, P = 0 13) and a higher proportion of patients were anti-TNF-naïve (3/17, 18% vs 18/24, 74%, P = 0 0004) There was a reduction in use of concomitant immunomodulators (22/29, 76% vs 4/34, 12%, P < 0 0001) and increased biologic use in thiopurine-naïve patients (3/37, 8% vs 15/36, 42%, P = 0 001) Use of TDM fell by 75% (240 vs 59 tests) Outpatient appointments fell by 68% and were conducted via telemedicine MRI scanning, endoscopy, luminal surgery and inpatient numbers fell by 87%, 85%, 100% and 82% respectively IBD Clinical Nurse Specialist and Pharmacist helpline contacts increased by 76% and 228% respectively Conclusions: We observed prescribing differences during COVID-19, bypassing the initiation of immunomodulators and/or anti-TNF therapy in favour of vedolizumab with a reduction in immunomodulator prescribing We also observed a rapid reorganisation of service provision, including a shift towards telemedicine and online solutions
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