Inflammatory bowel disease–dermatology: evaluation of a collaborative, multidisciplinary, patient-centred care model

Objective Skin disease is common in patients with inflammatory bowel disease (IBD). Patients with severe cutaneous disease often require multidisciplinary management, typically delivered through several separate consultations/discussions limiting direct patient involvement. To facilitate holistic, patient-centred, multidisciplinary care, we established a combined gastroenterology–dermatology clinic (GDC) to enable simultaneous dual specialty face-to-face assessment with shared decision making. We aimed to report the first 3 years of GDC experience alongside patient satisfaction. Method We reviewed electronic health records of patients reviewed in the GDC between July 2021 and July 2024 and distributed an anonymous patient satisfaction survey to those attending in July 2023. Results 66 patients attended 173 consultations across 15 3-monthly clinics. The majority had IBD (91%, n=60; Crohn’s disease (CD) n=49 (74%), ulcerative colitis n=10 (15%), orofacial granulomatosis n=1). Other gastroenterological diagnoses included lymphocytic colitis (n=1), bile acid malabsorption (n=1), coeliac disease (n=1) and mast cell activation syndrome (n=1). The most common dermatological diseases were hidradenitis suppurativa (n=20, 30%), atopic eczema (n=12, 18%), psoriasis (n=19, 29%), cutaneous CD (n=11, 17%) and neutrophilic dermatoses (Sweet syndrome, bowel-associated dermatitis–arthritis syndrome or pyoderma gangrenosum, n=6, 9%). 55 patients (83%) received biologics or small molecules with proactive initiation, switching or optimisation of therapy. 10 patients completed a satisfaction survey with a median score of 50 out of 50 (IQR: 50–50). Conclusion This service evaluation demonstrates the value of a GDC in simultaneous, cross-specialty patient-centred management of multiple immune conditions. Our service can be used as a template for other hospitals to replicate this care model.