Skip to main content
SpringerLink
Log in
Book cover

Inflammatory Bowel Disease Nursing Manual pp 453–462Cite as

Clinics

  • Chapter
  • First Online:

  • 1396 Accesses

Abstract

Inflammatory bowel disease is a lifelong, chronic condition consisting of two main subtypes: ulcerative colitis (UC) and Crohn’s disease (CD). It is often characterized by an unpredictable disease course with fluctuating periods of quiescence and flares despite optimal therapy. As a result, the clinical management of patients with IBD requires flexibility. The majority of patients are managed in an outpatient setting. An outpatient clinic schedule aims to accommodate prompt access appointments for those patients who are experiencing exacerbation of their disease and for those who are experiencing side effects to medical therapy.

Nurses play a key role within the multidisciplinary team by providing clinical support and education and serving as a patient advocate. In a traditional clinic setting where face-to-face follow-up appointments are scheduled at the time of the clinic visit, there is a shortage of available clinic time for urgent, frequent, or prompt medical appointments. As a result, many specialist IBD nurses are filling in the required gap by setting up nurse-led follow-up clinics for prompt access or frequent follow-up appointments within the chronic disease model of care for IBD patients.

The onset of IBD is usually during teen years or young adult life, requiring frequent follow-up clinic visits which can disrupt family members’ daily life to facilitate the scheduled clinic appointment. As a consequence, creative ways of conducting follow-up appointment are being considered through virtual clinic follow-up visits, telephone follow-up visits, or distance self-management. This chapter will cover face-to-face and virtual clinic appointment; however, telephone review and distance management will be discussed more in the e-health (44) and advice line (47) chapters.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Alarhayem A, Achebe E, Logue AJ (2015) Psychosocial support of the inflammatory bowel disease patient. Surg Clin North Am 95(6):1281–1293

    Article  Google Scholar 

  • Baldassano R, Ferry G, Griffiths A, Mack D, Markowitz J, Winter H (2002) Transition of the patient with inflammatory bowel disease from pediatric to adult care: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 34(3):245–248

    Article  Google Scholar 

  • Balzola F, Cullen G, Ho GT, Hoentjen F, Russell RK (2013) Decreasing colectomy rates for ulcerative colitis: a population-based time trend study. Inflamm Bowel Dis 13(3):122

    Google Scholar 

  • Bennebroek Evertsz’ F, Thijssens NAM, Stokkers PCF, Grootenhuis MA, Bockting CLH, Nieuwkerk PT et al (2012) Do inflammatory bowel disease patients with anxiety and depressive symptoms receive the care they need? J Crohns Colitis 6(1):68–76

    Article  Google Scholar 

  • Bollegala N, Nguyen GC (2015) Transitioning the adolescent with IBD from pediatric to adult care: a review of the literature. Gastroenterol Res Pract 2015:7

    Article  Google Scholar 

  • Brooks AJ, Rowse G, Ryder A, Peach EJ, Corfe BM, Lobo AJ (2016) Systematic review: psychological morbidity in young people with inflammatory bowel disease - risk factors and impacts. Aliment Pharmacol Ther 44(1):3–15

    Article  CAS  Google Scholar 

  • Cheung WY, Dove J, Lervy B, Russell IT, Williams JG (2002) Shared care in gastroenterology: GPs’ views of open access to out-patient follow-up for patients with inflammatory bowel disease. Fam Pract 19(1):4–6

    Article  Google Scholar 

  • de Lima A, Zelinkova Z, Mulders AGMGJ, van der Woude CJ (2016) Preconception care reduces relapse of inflammatory bowel disease during pregnancy. Clin Gastroenterol Hepatol 14(9):1285–1292.e1

    Article  Google Scholar 

  • Farraye FA, Melmed GY, Lichtenstein GR, Kane SV (2017) ACG clinical guideline: preventive care in inflammatory bowel disease. Am J Gastroenterol 112(2):241–258

    Article  Google Scholar 

  • Frolkis AD, Dykeman J, Negrón ME, Debruyn J, Jette N, Fiest KM et al (2013) Risk of surgery for inflammatory bowel diseases has decreased over time: A systematic review and meta-analysis of population-based studies. Gastroenterology 145(5):996–1006

    Article  Google Scholar 

  • Goodhand J, Hedin CR, Croft NM, Lindsay JO (2011) Adolescents with IBD: the importance of structured transition care. J Crohns Colitis 5(6):509–519

    Article  CAS  Google Scholar 

  • Graff LA, Walker JR, Bernstein CN (2009) Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis 15(7):1105–1118

    Article  Google Scholar 

  • Halmos EP, Gibson PR (2015) Dietary management of IBD--insights and advice. Nat Rev Gastroenterol Hepatol 12(3):133–146

    Article  CAS  Google Scholar 

  • Hamlin PJ, Warren L, Everett SM (2011) Establishing a biologics service for patients with inflammatory bowel disease. Frontline Gastroenterol 2(3):133–139

    Article  CAS  Google Scholar 

  • Häuser W, Moser G, Klose P, Mikocka-walus AA (2014) Psychosocial issues in evidence-based guidelines on inflammatory bowel diseases: a review. World J Gastroenterol 20(13):3666–3671

    Article  Google Scholar 

  • Hendy P, Chadwick G, Hart A (2015) IBD: reproductive health, pregnancy and lactation. Frontline Gastroenterol 6:38–43

    Article  Google Scholar 

  • Hunter J, Claridge A, James S, Chan D, Stacey B, Stroud M et al (2012) Improving outpatient services: the Southampton IBD virtual clinic. Postgrad Med J 88(1042):487–491

    Article  Google Scholar 

  • IBD Standards (2013) Standards for the healthcare of people who have Inflammatory Bowel Disease (IBD) IBD Standards, pp 1–32

    Google Scholar 

  • Kahn SA (2014) Transition of care in inflammatory bowel disease. Gastroenterol Hepatol 10(10):633–640

    Google Scholar 

  • Kemp K, Campbell S, Kemp K, Griffiths J, Campbell S, Lovell K (2013) An exploration of the follow-up needs of patients with inflammatory bowel disease an exploration of the follow-up up needs of patients with inflammatory bowel disease. J Crohn’s Colitis 7(9):e386–e395. European Crohn’s and Colitis Organisation

    Article  Google Scholar 

  • Lomer MCE (2011) Dietary and nutritional considerations for inflammatory bowel disease. Proc Nutr Soc 70(3):329–335

    Article  CAS  Google Scholar 

  • Louis E, Dotan I, Ghosh S, Mlynarsky L, Reenaers C, Schreiber S (2015) Optimising the inflammatory bowel disease unit to improve quality of care: expert recommendations. J Crohns Colitis 9(8):685–691

    Article  Google Scholar 

  • Mikocka-walus AA, Andrews JM, Ka R, Von Moser G (2013) What are the implications of changing treatment delivery models for patients with inflammatory bowel disease: a discussion paper. Eur J Gastroenterol Hepatol 25(4):393–398

    Article  Google Scholar 

  • Mikocka-Walus A, Andrews JM, Rampton D, Goodhand J, van der Woude J, Bernstein CN (2014) How can we improve models of care in inflammatory bowel disease? An international survey of IBD health professionals. J Crohns Colitis 8(12):1668–1674

    Article  Google Scholar 

  • Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G et al (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142(1):46–54.e42

    Article  Google Scholar 

  • Morar P, Read J, Arora S, Hart A, Warusavitarne J, Green J et al (2015) Defining the optimal design of the inflammatory bowel disease multidisciplinary team: results from a multicentre qualitative expert-based study. Frontline Gastroenterol 6:290–297

    Article  Google Scholar 

  • Nguyen GC, Seow CH, Maxwell C, Huang V, Leung Y, Jones J et al (2016) The Toronto Consensus statements for the management of inflammatory bowel disease in pregnancy. Gastroenterology 150(3):734–757e1

    Article  Google Scholar 

  • O’Connor M, Bager P, Duncan J, Gaarenstroom J, Younge L, Détré P et al (2013) N-ECCO Consensus statements on the European nursing roles in caring for patients with Crohn’s disease or ulcerative colitis. J Crohns Colitis 7(9):744–764

    Article  Google Scholar 

  • Panés J, O’Connor M, Peyrin-Biroulet L, Irving P, Petersson J, Colombel JF (2014) Improving quality of care in inflammatory bowel disease: What changes can be made today? J Crohn’s Colitis 8(9):919–926

    Article  Google Scholar 

  • Paterson WG, Depew WT, Paré P, Petrunia D, Switzer C, Veldhuyzen van Zanten SJ et al (2006) Canadian consensus on medically acceptable wait times for digestive health care. Can J Gastroenterol 20(6):411–423

    Article  Google Scholar 

  • Richman E, Rhodes JM (2013) Review article: evidence-based dietary advice for patients with inflammatory bowel disease. Aliment Pharmacol Ther 38(10):1156–1171

    Article  CAS  Google Scholar 

  • Robinson A, Thompson DG, Wilkin D, Roberts C (2001) Guided self-management and patient-directed follow-up of ulcerative colitis: a randomised trial. Lancet 358(9286):976–981

    Article  CAS  Google Scholar 

  • Sack C, Phan VA, Grafton R, Holtmann G (2012) A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease. J Crohns Colitis 6(3):302–310

    Article  CAS  Google Scholar 

  • Stelton S, Zulkowski K, Ayello EA (2015) Practice implications for peristomal skin assessment and care from the 2014 world council of enterostomal therapists international ostomy guideline. Adv Skin Wound Care 28(6):275–284

    Article  Google Scholar 

  • Van Dullemen HM, Kleibeuker JH (2016) Novel approaches in the outpatient care of patients with chronic inflammatory bowel disease. 5521(December)

    Google Scholar 

  • Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001) Improving chronic illness care: translating evidence into action. Health Aff 20(6): 64–78

    Article  CAS  Google Scholar 

  • Ward M (2016) Research topic: managing compassionate therapy — the role of the virtual clinic. J Gastroenterol Hepatol 31:44–45

    Article  Google Scholar 

  • Whear R, Abdul-Rahman A-K, Thompson-Coon J, Boddy K, Perry MG, Stein K (2013a) Patient initiated clinics for patients with chronic or recurrent conditions managed in secondary care: a systematic review of patient reported outcomes and patient and clinician satisfaction. BMC Health Serv Res 13(1):501

    Article  Google Scholar 

  • Whear R, Boddy K, Thompson-coon J, Perry M, Stein K (2013b) The clinical effectiveness of patient initiated clinics for patients with chronic or recurrent conditions managed in secondary care: a systematic review. PLoS One 8(10):e74774

    Article  CAS  Google Scholar 

  • Zhang CK, Hewett J, Hemming J, Grant T, Zhao H, Abraham C et al (2013) The influence of depression on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis 19(8):1732–1739

    Article  Google Scholar 

  • Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hamilton Health Sciences, McMaster University Medical Centre, Hamilton, ON, Canada

    Usha Chauhan

Authors
  1. Usha Chauhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Usha Chauhan .

Editor information

Editors and Affiliations

  1. DRK Kliniken Berlin Westend, Department of Gastroenterology, Berlin, Germany

    Andreas Sturm

  2. Gastroenterology Level 5, John Radcliffe Hospital, Oxford, UK

    Lydia White

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chauhan, U. (2019). Clinics. In: Sturm, A., White, L. (eds) Inflammatory Bowel Disease Nursing Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-75022-4_48

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75022-4_48

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75021-7

  • Online ISBN: 978-3-319-75022-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation