The SILVER Platter for Patients with Inflammatory Bowel Disease (IBD): An IBD Pharmacy Technician-Led Subcutaneous...

Subcutaneous medications are associated with lower adherence, risking adverse disease outcomes. This project aimed to evaluate the effect of a pharmacy technician-led subcutaneous biologic home delivery (SILVER) service on medication adherence, health literacy, and disease outcomes in patients with inflammatory bowel disease (IBD).

Patients treated with a subcutaneous biologic, residing within 45 min of a tertiary IBD service, were offered home delivery of the biologic. Demographic and clinical data were recorded. Telephone interviews at baseline, 6 months, and 12 months were performed to evaluate change in quality of life via Short Inflammatory Bowel Disease Questionnaire (SIBDQ), medication adherence, health literacy via Health Literacy Questionnaire, and electronic Health Literacy Questionnaire (HLQ & eHLQ) and clinical disease activity.

Eighty patients were included. 45 (56.3%) patients were treated with ustekinumab, 23 (28.8%) with adalimumab, 11 (13.8%) with subcutaneous infliximab and 1 (1.2%) with subcutaneous vedolizumab. Significant improvement (p ≤ 0.05) was observed at 6 and 12 months in SIBDQ, adherence, and HLQ/eHLQ (two domains), and fecal calprotectin at 6 months. Of these patients, 43 were treated with the same biologic agent and route for at least 6 months prior to enrollment. In this subgroup, significant improvement (p ≤ 0.05) was measured at 6 and 12 months in SIBDQ, adherence, and HLQ/eHLQ (one domain).

A novel pharmacy technician-led subcutaneous biologic home delivery service was associated with improvement in IBD-related quality of life, medication adherence, health literacy, and disease outcomes, sustained to 12 months. Larger studies are warranted to evaluate home delivery of subcutaneous biologics in IBD.