Models of outpatient care delivery in inflammatory bowel disease: a scoping review

Noelle Rohatinsky; M Ellen Kuenzig; James Im; Melissa Huestis; Tasbeen Akhtar Sheekha; Cynthia H Seow; Gilaad G Kaplan; Geoffrey C Nguyen; Eric I Benchimol

doi:10.1093/jcag/gwaf031

Models of outpatient care delivery in inflammatory bowel disease: a scoping review

J Can Assoc Gastroenterol. 2025 Nov 19;8(6):267-287. doi: 10.1093/jcag/gwaf031. eCollection 2025 Dec.

Authors

Noelle Rohatinsky¹, M Ellen Kuenzig^{2

3

4

5

6}, James Im^{2

3}, Melissa Huestis^{2

3}, Tasbeen Akhtar Sheekha¹, Cynthia H Seow⁷, Gilaad G Kaplan⁷, Geoffrey C Nguyen^{6

8

9}, Eric I Benchimol^{2

3

6

8

10}

Affiliations

¹ College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 2Z4, Canada.
² SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children (SickKids), Toronto, Ontario, M5G 1X8, Canada.
³ Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada.
⁴ Department of Paediatrics and Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, N6G 2M1, Canada.
⁵ Children's Health Research Institute, London, Ontario, N6C 2V5, Canada.
⁶ ICES, Toronto, Ontario, M4N 3M5, Canada.
⁷ Departments of Medicine & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada.
⁸ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, M5T 3M6, Canada.
⁹ Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Department of Medicine, University of Toronto, Toronto, Ontario, M5G 1X5, Canada.
¹⁰ Department of Paediatrics, University of Toronto, Toronto, Ontario, M5G 1X8, Canada.

Abstract

Background: As inflammatory bowel disease (IBD) becomes increasingly common worldwide, optimizing service delivery is critical to ensuring timely access to high-quality IBD care. We conducted a scoping review to understand the extent and type of evidence related to models of outpatient IBD care.

Methods: We searched MEDLINE, EMBASE, CINAHL, and PsycINFO from inception to April 29, 2025 to identify English-language studies describing or evaluating models of care delivery for individuals with IBD in outpatient settings. Eligible peer-reviewed articles included publications of any type (primary studies, reviews, perspectives) focusing on any age group, timepoints in care (eg, transition from pediatric to adult care), and context (eg, remote delivery).

Results: Of the 14,202 records searched, 243 met the inclusion criteria, including 89 studies evaluating models of care, 141 studies describing models of care without formal evaluation, and 13 consensus statements/guidelines. Models discussed included value-based multidisciplinary teams (with either biomedical or biopsychosocial approaches), care provided by nurses and other allied healthcare professionals (HCPs), remote monitoring and healthcare delivery, and rapid access clinics. Models increased patient satisfaction, enhanced collaboration between patients and HCPs, reduced health services utilization (eg, emergency department visits, hospitalizations), and improved patient outcomes (ie, disease activity, mental health, quality of life). Gastroenterologists, IBD nurses, and allied HCPs were consistently identified as key team members.

Conclusions: Innovative outpatient models of IBD care have been proposed and evaluated. These models of care can guide modifications to IBD care globally to help address the rising demand of IBD on healthcare systems, increasing the efficiency of care.

Keywords: Crohn’s disease; care delivery; ulcerative colitis.