Rapid access outpatient service utilisation among patients with chronic intestinal failure receiving home parenteral...

There is a notable lack of data on healthcare utilisation for patients with chronic intestinal failure (CIF) outside of hospitalisation. Rapid access outpatient services are the first point of contact for patients in the community and play a key role in the continuous management of CIF. The aim of this study was therefore to evaluate the rapid access outpatient services utilisation by patients with CIF.

This was a descriptive cohort study in adults with benign CIF under the care of a U.K. National Reference Centre for Intestinal Failure between 2020 and 2024. Data were collected on the outpatient contact with the rapid access service including the attendance to the rapid access outpatient clinic and remote contact with the weekly rapid access "troubleshoot" service from patients in the community.

In total, 511 patients were included in the analysis. During the study period, 67.3% patients attended the rapid access outpatient clinic with 1796 visits. The most common reason for attendance were catheter-related issues, abdominal wound care and clinical review by a member of the IF multi-disciplinary team. Overall, 65.1% rapid access clinic appointments were deemed to have prevented admission. During the study period, 34.2% patients were discussed remotely during the rapid access troubleshoot meeting with a total of 276 separate patient events discussed. The commonest reasons included catheter-related issues, gastrointestinal symptoms and nutritional optimisation.

To our knowledge, this is the first study to specifically characterise the utilisation of a dedicated rapid-access outpatient and remote troubleshooting service for patients with CIF receiving home parenteral support. Our findings suggest that rapid access outpatient services provide substantial specialist support for the management of routine and urgent clinical issues, facilitating timely intervention, optimising care delivery in the community as well as reducing the hospitalisation to the specialised IF unit.