{
  "abstract": "Introduction Rheumatological co-morbidities are common in patients with Inflammatory bowel disease (IBD), yet multidisciplinary care is often fragmented, with discussions and treatment decisions frequently occurring without the patient present. To address this and provide a more patient-centred model, a combined Gastroenterology–Rheumatology Clinic (GRC) was established to deliver real-time, multidisciplinary assessment and support shared decision-making. This service evaluation describes the GRC cohort, service impact and patient feedback over its first four years.Methods A retrospective review of electronic clinical records was conducted for all patients seen in the GRC between June 2021 and September 2025. An anonymous patient satisfaction survey was distributed to clinic attendees in June and September 2025.Results Across 17 clinics, 63 patients were reviewed over 130 appointments. Most patients (59, 94%) had IBD: Crohn’s ­disease 42 (71%), ulcerative colitis 15 (25%) and IBD-unclassified 2 (3%). Among those with Crohn’s disease, 19 (45%) had stricturing or penetrating behaviour (B2/B3), and 21 (50%) had ileocolonic disease (L3). Extensive colitis (E3) was present in 6 (40%) patients with ulcerative colitis. Prior intestinal resection had been performed in 26 patients with IBD (44%).Inflammatory arthritis was present in 51 patients (81%): isolated axial spondyloarthritis 20 (39%), isolated peripheral arthritis 21 (41%), and combined axial and peripheral disease 10 (20%). Among those with axial involvement, mean baseline Bath Axial Spondyloarthritis Disease Activity Index (BASDAI) was 6.2 (SD 2.5; n=21), indicating high disease activity. Other rheumatological diagnoses included rheumatoid arthritis (1, 2%) and polymyalgia rheumatica (2, 3%), while 10 patients (16%) had non-inflammatory musculoskeletal pain.At first GRC review, 52 patients (83%) had received at least one advanced therapy. During follow-up, 40 patients (63%) had medication changes; the most frequent class switches were anti-TNF to anti-IL-12/23 (n=5) and IL-12/23 to JAK inhibitor (n=4). Non-medication-related actions (e.g. investigations or referrals) were undertaken for 47 patients (75%). Overall, 100 appointments (77%) across 60 patients (95%) resulted in a treatment change or other clinical intervention.Among 19 survey respondents, the median satisfaction score was 50 out of 50 (IQR 49–50).Conclusions The GRC cohort was clinically complex with a high prevalence of advanced disease phenotypes, prior advanced therapy use, and previous surgery. The frequency of treatment changes and other clinical interventions highlights the added value of integrated specialist review, while patient feedback demonstrates strong acceptance of this model. These findings support the continued development and wider adoption of joint gastroenterology–rheumatology pathways within IBD care.",
  "authors": [
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom",
        "Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Robert J Mulligan"
    },
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom",
        "Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "James A Stanway"
    },
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom",
        "Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "R Ally Speight"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Ejaz MI Pathan"
    },
    {
      "affiliations": [
        "Department of Dermatology and NIHR Biomedical Research Centre, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Amaani B Hussain"
    },
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Lauren C Beck"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Ben Thompson"
    },
    {
      "affiliations": [
        "Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom",
        "Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Christopher A Lamb"
    }
  ],
  "title": "P231 Evaluating the impact of a combined gastroenterology-rheumatology clinic for patients with IBD",
  "uid": "93cc84f5-03cf-5917-b9ce-3a3d14a55831"
}