A Nurse-Driven Outpatient Clinic for Thiopurine-Treated Inflammatory Bowel Disease Patients Reduces Physician Visits and Increases Follow-Up Efficiency

María López, Angelina Dosal, Albert Villoria, Laura Moreno, Xavier Calvet

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

© Copyright 2015 Society of Gastroenterology Nurses and Associates. Unauthorized reproduction of this article is prohibited. Patients on thiopurine therapy need frequent monitoring to prevent drug adverse events. To describe the structure and main results of a nurse-driven outpatient clinic (NDOC) program for the follow-up of patients receiving treatment with thiopurine immunosuppressants, we retrospectively reviewed patients' clinical charts on thiopurine drugs, azathioprine (AZA), and 6-mercaptopurine. We evaluated the efficacy of the NDOC by comparing the number of physician visits and the adequacy of laboratory controls for each patient before and after inclusion in the program. From January 2006 to December 2008, 179 patients were included. Of these, 102 had received thiopurines for at least 1 year before the start of the NDOC. Mean age was 42 ± 15 years; 83 were female. In all, 137 of the 179 patients (76%) had Crohn disease. AZA was the most frequent drug used (97%). Mean time of follow-up was 2.03 ± 0.9 years. Implementation of this program decreased the number of physician visits per year - from 4.6 ± 1.9 to 2.4 ± 1.3 (p <.001) - and the number of periods longer than 4 months without laboratory control (from 68% to 45%; p =.01). Leucopenia episodes and complications did not differ significantly before and after the start of the NDOC. Nurse-driven follow-up of these patients reduces physician visits while improving tightness of the follow-up.
Original languageEnglish
Pages (from-to)116-120
JournalGastroenterology Nursing
Volume38
DOIs
Publication statusPublished - 1 Dec 2015

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