Prospective evaluation of a nurse-led IBD advice line in Asia: clinical utility, safety and carbon footprint analysis

Objective To evaluate clinical utility, short-term safety outcomes and environmental implications of a nurse-led inflammatory bowel disease (IBD) advice line in an Asian tertiary centre. Method We conducted a 12-month service evaluation of all patient-initiated contacts to a nurse-led IBD advice line at Singapore General Hospital. Response timeliness was assessed against predefined standards (<24 hours on weekdays, <72 hours on weekends). Encounters were categorised as clinical or administrative. Clinical encounters with complete data underwent independent adjudication of nursing activities and clinical impact. Safety outcomes included emergency department (ED) attendance within 7 days and unplanned hospitalisation within 30 days. Travel-related environmental impact was estimated from encounters adjudicated as averted unscheduled clinic visits. Results A total of 527 contacts from 173 patients were recorded (median age 36 years; 61.3% male); 76.3% receiving biologics; 91.5% met response standards. Of 527 encounters, 160 (30.4%) were clinical and 367 (69.6%) administrative; 122 clinical encounters were analysed for impact. Common nursing activities included education/counselling (83.6%) and clinical assessment (64.8%). Clinician-adjudicated impacts included remote care optimisation (47.5%), expedited review within 7 days (18.0%), avoidance of unscheduled clinic visits (26.2%) and avoidance of ED visits (20.5%). ED attendance within 7 days occurred in 5.7% (mostly nurse directed); unplanned hospitalisation occurred in 0.8%. 32 encounters were associated with avoided travel (median 32.5 km), corresponding to 2.3–5.5 kg CO ₂ e avoided per encounter. Conclusion A nurse-led IBD advice line enabled timely triage with reassuring safety and potential reductions in unscheduled care and travel-related emissions.