Changing face of care for patients with moderate to severe inflammatory bowel disease

The role of specialist nurses in the governance of anti-TNF prescribing

William R Connell, Tamie Samyue, Peter Raymond Gibson, Shamilah Lachal, Gregory Thomas Charles Moore, Finlay A Macrae, Daniel Van Langenberg

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Backgorund: Anti-tumour necrosis factor (TNF) therapy is highly effective for inflammatory bowel disease (IBD), but expensive and potentially toxic. Meticulous supervision prior to and during anti-TNF treatment is required to screen and monitor patients for adverse clinical events. In addition, a systematic administrative process is necessary to comply with Australian Medicare requirements and ensure ongoing therapy is uninterrupted. IBD nurses are essential components of multidisciplinary IBD services, but their role in facilitating the safe and timely delivery of anti-TNF drugs is unacknowledged. Aim: The aim of the study was to calculate time spent by IBD nurses on anti-TNF drug governance and its indirect cost.
Methods: Time spent on activities related to anti-TNF governance was retrospectively assessed by questionnaire among IBD nurses employed at Melbourne hospitals. The capacity of IBD clinics at these hospitals was separately evaluated by surveying medical heads of clinics.
Results: On average, each Melbourne IBD service handled 150 existing and 40 new anti-TNF referrals in 2013. The average annual time spent by nurses supervising an existing and newly referred anti-TNF patient was 3.5 and 5.25 h respectively, or a minimum of two full working days per week. If clinicians undertook this activity during normal clinic time, the organisational opportunity cost was at least 58.
Conclusions: Anti-TNF therapy governance is an essential quality component of IBD care that is associated with a definite, indirect cost for every patient treated. IBD nurses are best positioned to undertake this role, but an activity-based funding model is urgently required to resource this element of their work.
Original languageEnglish
Pages (from-to)1161 - 1166
Number of pages6
JournalInternal Medicine Journal
Volume45
Issue number11
DOIs
Publication statusPublished - 2015

Cite this

@article{645c661d7beb4715a8740621d4dec3b1,
title = "Changing face of care for patients with moderate to severe inflammatory bowel disease: The role of specialist nurses in the governance of anti-TNF prescribing",
abstract = "Backgorund: Anti-tumour necrosis factor (TNF) therapy is highly effective for inflammatory bowel disease (IBD), but expensive and potentially toxic. Meticulous supervision prior to and during anti-TNF treatment is required to screen and monitor patients for adverse clinical events. In addition, a systematic administrative process is necessary to comply with Australian Medicare requirements and ensure ongoing therapy is uninterrupted. IBD nurses are essential components of multidisciplinary IBD services, but their role in facilitating the safe and timely delivery of anti-TNF drugs is unacknowledged. Aim: The aim of the study was to calculate time spent by IBD nurses on anti-TNF drug governance and its indirect cost. Methods: Time spent on activities related to anti-TNF governance was retrospectively assessed by questionnaire among IBD nurses employed at Melbourne hospitals. The capacity of IBD clinics at these hospitals was separately evaluated by surveying medical heads of clinics. Results: On average, each Melbourne IBD service handled 150 existing and 40 new anti-TNF referrals in 2013. The average annual time spent by nurses supervising an existing and newly referred anti-TNF patient was 3.5 and 5.25 h respectively, or a minimum of two full working days per week. If clinicians undertook this activity during normal clinic time, the organisational opportunity cost was at least 58. Conclusions: Anti-TNF therapy governance is an essential quality component of IBD care that is associated with a definite, indirect cost for every patient treated. IBD nurses are best positioned to undertake this role, but an activity-based funding model is urgently required to resource this element of their work.",
author = "Connell, {William R} and Tamie Samyue and Gibson, {Peter Raymond} and Shamilah Lachal and Moore, {Gregory Thomas Charles} and Macrae, {Finlay A} and {Van Langenberg}, Daniel",
year = "2015",
doi = "10.1111/imj.12861",
language = "English",
volume = "45",
pages = "1161 -- 1166",
journal = "Internal Medicine Journal",
issn = "1444-0903",
publisher = "Wiley-Blackwell",
number = "11",

}

Changing face of care for patients with moderate to severe inflammatory bowel disease : The role of specialist nurses in the governance of anti-TNF prescribing. / Connell, William R; Samyue, Tamie; Gibson, Peter Raymond; Lachal, Shamilah; Moore, Gregory Thomas Charles; Macrae, Finlay A; Van Langenberg, Daniel.

In: Internal Medicine Journal, Vol. 45, No. 11, 2015, p. 1161 - 1166.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Changing face of care for patients with moderate to severe inflammatory bowel disease

T2 - The role of specialist nurses in the governance of anti-TNF prescribing

AU - Connell, William R

AU - Samyue, Tamie

AU - Gibson, Peter Raymond

AU - Lachal, Shamilah

AU - Moore, Gregory Thomas Charles

AU - Macrae, Finlay A

AU - Van Langenberg, Daniel

PY - 2015

Y1 - 2015

N2 - Backgorund: Anti-tumour necrosis factor (TNF) therapy is highly effective for inflammatory bowel disease (IBD), but expensive and potentially toxic. Meticulous supervision prior to and during anti-TNF treatment is required to screen and monitor patients for adverse clinical events. In addition, a systematic administrative process is necessary to comply with Australian Medicare requirements and ensure ongoing therapy is uninterrupted. IBD nurses are essential components of multidisciplinary IBD services, but their role in facilitating the safe and timely delivery of anti-TNF drugs is unacknowledged. Aim: The aim of the study was to calculate time spent by IBD nurses on anti-TNF drug governance and its indirect cost. Methods: Time spent on activities related to anti-TNF governance was retrospectively assessed by questionnaire among IBD nurses employed at Melbourne hospitals. The capacity of IBD clinics at these hospitals was separately evaluated by surveying medical heads of clinics. Results: On average, each Melbourne IBD service handled 150 existing and 40 new anti-TNF referrals in 2013. The average annual time spent by nurses supervising an existing and newly referred anti-TNF patient was 3.5 and 5.25 h respectively, or a minimum of two full working days per week. If clinicians undertook this activity during normal clinic time, the organisational opportunity cost was at least 58. Conclusions: Anti-TNF therapy governance is an essential quality component of IBD care that is associated with a definite, indirect cost for every patient treated. IBD nurses are best positioned to undertake this role, but an activity-based funding model is urgently required to resource this element of their work.

AB - Backgorund: Anti-tumour necrosis factor (TNF) therapy is highly effective for inflammatory bowel disease (IBD), but expensive and potentially toxic. Meticulous supervision prior to and during anti-TNF treatment is required to screen and monitor patients for adverse clinical events. In addition, a systematic administrative process is necessary to comply with Australian Medicare requirements and ensure ongoing therapy is uninterrupted. IBD nurses are essential components of multidisciplinary IBD services, but their role in facilitating the safe and timely delivery of anti-TNF drugs is unacknowledged. Aim: The aim of the study was to calculate time spent by IBD nurses on anti-TNF drug governance and its indirect cost. Methods: Time spent on activities related to anti-TNF governance was retrospectively assessed by questionnaire among IBD nurses employed at Melbourne hospitals. The capacity of IBD clinics at these hospitals was separately evaluated by surveying medical heads of clinics. Results: On average, each Melbourne IBD service handled 150 existing and 40 new anti-TNF referrals in 2013. The average annual time spent by nurses supervising an existing and newly referred anti-TNF patient was 3.5 and 5.25 h respectively, or a minimum of two full working days per week. If clinicians undertook this activity during normal clinic time, the organisational opportunity cost was at least 58. Conclusions: Anti-TNF therapy governance is an essential quality component of IBD care that is associated with a definite, indirect cost for every patient treated. IBD nurses are best positioned to undertake this role, but an activity-based funding model is urgently required to resource this element of their work.

UR - http://onlinelibrary.wiley.com/doi/10.1111/imj.12861/epdf

U2 - 10.1111/imj.12861

DO - 10.1111/imj.12861

M3 - Article

VL - 45

SP - 1161

EP - 1166

JO - Internal Medicine Journal

JF - Internal Medicine Journal

SN - 1444-0903

IS - 11

ER -