Quality improvement initiative reduces time to administer biologics, ER visits in IBD

A quality improvement (QI) intervention is associated with reduced medication administration times for biologic therapy by fast-tracking provider-dependent steps and with fewer emergency room (ER) visits, reveals a recent study.

“Delays in biologic or small molecule medication administration are associated with increased adverse events, hospitalization, and surgery in inflammatory bowel disease (IBD),” the investigators said.

This study aimed to assess the impact of a QI initiative on the time to administration of biologics or small molecules (TABS) in IBD. The investigators retrospectively obtained data for IBD patients prescribed these medications from a convenience sample of providers participating in an accredited QI educational intervention (baseline cohort).

After the intervention, data were prospectively collected from participants (postintervention cohort). The investigators also gathered dates related to steps between a treatment decision to medication administration. TABS in baseline and postintervention cohorts was the primary outcome.

Eighteen physicians provided survey and patient data for 400 patients (200 in each cohort). The median TABS decreased from baseline to postintervention cohorts (30 vs 26 days; p=0.04), as did ER visits before medication administration (25.5 percent vs 12.5 percent; p=0.001).

Numerical TABS reductions were similar in subgroups limited to physicians providing patients to both cohorts and for individual medications prescribed. Of note, the primary contributors to delays were filling prescriptions after insurance approval and dispensation subsequent to this.

“We propose TABS as a quality metric to assess the effective delivery of therapies in IBD,” the investigators said. “Further evaluation of QI interventions, patient education on prescription drug insurance, and quality metrics are warranted.”