Defining the Roles of Inflammatory Bowel Disease Clinical Pharmacists in the United States: A Systematic Review and National RAND/UCLA Consensus

Shubha Bhat; Ruishen Lyu; Mitali Agarwal; Michelle Becker; Richard Bloomfeld; David H Bruining; Benjamin L Cohen; Marina Ivanov; Jonathan A Leighton; Alyssa P Stewart; Lindsay Trocke; Stacy S Tse; Ryan C Ungaro; Byron P Vaughn; Miguel Regueiro; Erick Sokn; Florian Rieder

doi:10.1093/ibd/izad143

Defining the Roles of Inflammatory Bowel Disease Clinical Pharmacists in the United States: A Systematic Review and National RAND/UCLA Consensus

Inflamm Bowel Dis. 2023 Aug 31:izad143. doi: 10.1093/ibd/izad143. Online ahead of print.

Authors

Shubha Bhat^{1

2}, Ruishen Lyu³, Mitali Agarwal², Michelle Becker⁴, Richard Bloomfeld⁵, David H Bruining⁶, Benjamin L Cohen², Marina Ivanov⁷, Jonathan A Leighton⁷, Alyssa P Stewart⁸, Lindsay Trocke⁹, Stacy S Tse¹⁰, Ryan C Ungaro¹¹, Byron P Vaughn¹², Miguel Regueiro², Erick Sokn¹, Florian Rieder^{2

13}

Affiliations

¹ Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA.
² Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA.
³ Department of Quantitative Health Science, Cleveland Clinic Foundation, OH, USA.
⁴ Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
⁵ Section of Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
⁶ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
⁷ Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA.
⁸ Department of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
⁹ Department of Gastroenterology, M Health Fairview, Minneapolis, MN, USA.
¹⁰ Susan and Leonard Feinstein IBD Clinical Center, Mount Sinai Hospital, New York, NY, USA.
¹¹ Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹² Department of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA.
¹³ Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, OH, USA.

PMID: 37650888
DOI: 10.1093/ibd/izad143

Abstract

Background: Given the complexity of inflammatory bowel disease (IBD) care, utilization of multidisciplinary teams is recommended to optimize outcomes. There is a growing recognition that clinical pharmacists should be an integral part of this care model. We sought to define the roles of IBD clinical pharmacists in the United States.

Methods: A national multidisciplinary expert panel of 12 gastroenterologists and clinical pharmacists practicing in IBD clinics was assembled. We used the RAND/University of California, Los Angeles appropriateness method, with a total of 281 statements generated based on a systematic literature review and expert opinion. Each statement was anonymously rated as appropriate, uncertain, or inappropriate in 2 rounds of voting.

Results: The number of publications evaluating the clinical pharmacists' roles in IBD is limited, primarily focusing on thiopurine initiation and monitoring, medication adherence, and switching to biosimilars. Medication education; medication initiation and monitoring; therapeutic drug monitoring; biosimilar management; health maintenance review; and transitions of care were deemed by the panel to be appropriate roles for IBD clinical pharmacists. In considering real-world settings, IBD clinical pharmacists should practice clinically under a predefined scope and primarily focus on complex treatments (eg, immunomodulators, biologics, and small molecules). Clinical pharmacists should also be included in practice settings with IBD specialized physicians. Additionally, clinical pharmacists caring for patients with IBD should be residency trained and board certified.

Conclusions: This consensus defines IBD clinical pharmacists' roles and provides a framework for embedded clinical pharmacists in IBD care.

Keywords: Crohn’s disease; inflammatory bowel disease; multidisciplinary teams; pharmacists; ulcerative colitis.

Abstract

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