Disclaimer
This podcast is for US healthcare professionals only and is intended to be listened to as it was originally produced by Pfizer. This podcast has been funded by Pfizer, and the participants have been compensated by Pfizer for their time. The healthcare professionals featured are sharing their own opinions based on their clinical experiences. This promotional activity is not certified for continuing medical education.

Narrator
Welcome to the latest episode in our podcast series, IBD TalkTract, sponsored by Pfizer and designed to engage healthcare leaders in conversations about inflammatory bowel disease (IBD) care management opportunities. Our podcasts feature IBD specialists involved in care innovation at their institutions.  

In this episode, we will discuss the importance of embedding clinical pharmacists into IBD care teams to support patients from treatment initiation through ongoing management.  

With the global rise in IBD prevalence, enhancing IBD care is top of mind for healthcare providers. In US adults, the prevalence rose by 123% from 2007 to 2016.¹ Currently, up to 3.1 million US adults are estimated to have the disease based on national survey data.² According to a recently published expert consensus, IBD is recognized to be a complex condition, and is treated with advanced therapies that must be closely monitored.³ Because of this complexity, there’s a growing need to utilize multidisciplinary IBD care teams, and clinical pharmacists can play an integral role.³

In our first IBD TalkTract podcast, panelists discussed the importance of integrating pharmacists into IBD care teams. Today, we’ll take a deeper dive into best practices for pharmacist integration by hearing about the experiences of our accomplished and inspiring guest, Dr David Choi. Dr Choi is a pharmacist and serves as the Associate Director and Clinical Pharmacy Specialist of the Inflammatory Bowel Disease Center at the University of Chicago.  

Welcome to our podcast, David!  

David Choi
Thank you for having me.  

Narrator

To start us off, can you tell us about the Inflammatory Bowel Disease Center at your institution and the role you play there?  

David Choi
Sure. The University of Chicago Medicine Inflammatory Bowel Disease Center is an internationally recognized, tertiary referral center with an interprofessional approach to caring for patients. We have a comprehensive team that includes gastroenterologists, advanced practice providers, nurses, dietitians, psychologists, dedicated schedulers, and an embedded pharmacy team.  

As Associate Director, I serve as the liaison between the IBD Center and pharmacy services my focus is on helping to ensure the safe, effective, and timely initiation of IBD therapies. I’m also the point person for new drug launches and therapy planning, supporting the needs of our team and our patients.  

Narrator
That’s fantastic! Your team structure sounds incredibly comprehensive. You’ve written that clinical pharmacy teams can help increase the safe, effective, and timely initiation and continuation of IBD therapy.⁴ Could you share how your pharmacy team supports patients at your institution?    

David Choi
Our pharmacy team has 2 primary roles when it comes to optimizing patient care and outcomes.  

The first is operational, which is about access and affordability. Once a provider prescribes a specific IBD medication, our pharmacy technicians manage the benefits investigation, prior authorization submission, and appeals follow-up process if the request is denied. After approval, we will review affordability with the patients—walking them through copay options for commercial insurance and support programs.  

The second role our pharmacy team plays is clinical; we provide detailed new-start education for every therapy. That includes reviewing how to store, administer, dose the medication, as well as discussing potential side effects. Once the prescription is fulfilled, we take a treat-to-target approach, following patients to help ensure therapy is initiated correctly and aiming to achieve clinical targets and treatment goals along the way.  

Narrator 
That’s a very thorough approach. Once patients start therapy, how do pharmacists stay involved in their ongoing management?  

David Choi
That’s a good question! So, the University of Chicago has between 4000 and 5000 IBD patients on IBD therapies, and unfortunately, the pharmacy team can’t follow every patient. But we closely manage a large subset through pharmacy-directed treat-to-target monitoring.  

We check in proactively at 2, 4, 8, and 12 weeks, and then again at 6 months and 1 year. At those times, we’re making treatment assessments and coordinating labs as needed in collaboration with the IBD care team. We just want to assess whether or not patients are doing well and on track towards their goals.  

Narrator 
Proactivity is so key to IBD care. Let’s talk about the broader team. How do pharmacists collaborate with gastroenterologists, advanced practice providers (APPs), and other specialists like nutritionists?  

David Choi 
Our multidisciplinary approach is one of the most amazing parts of working here. Nurses, physicians, APPs, we’re all on the same level and the same team. So, if a patient needs, for example, a consult with a dietitian, there are no communication and operational barriers that stand in the way. That’s the approach we take with every team member. We’re one team aligned around the patient, working together to deliver the best possible care.  

Narrator
Not all institutions have embedded pharmacists. How did that integration come about, and what challenges did you face in getting support from leadership?  

David Choi 
This is a very common question that I receive from other IBD centers or other IBD providers trying to navigate this process. Advanced IBD therapies have truly revolutionized our management of patients with IBD, but they have also made access and patient management much more complex. And every new therapy or nuance in the process adds to the challenge. It’s difficult for gastroenterologists and APPs to keep track of it all. And it takes time away from their ability to see and care for patients. The pharmacist can be instrumental in helping to streamline the process, improve access, optimize care, and reduce emergency room visits and hospitalization.  

All of this can generate direct and indirect revenue—metrics that the IBD team can take to leadership as justification for embedding pharmacists in their IBD center.  

Narrator 
That makes a lot of sense. Once you had leadership on board, how did you scale the program from there?  

David Choi 
Since 2018, we have seen a large increase in the number of referrals every year. So, it’s been necessary to scale the pharmacy program to meet this growth and to successfully get patients on therapy. We track outcomes to provide data-driven evidence of the value pharmacists provide. Most recently, we’ve shown that we have a 98% success rate of getting patients on their intended therapy.⁴

Narrator 
That is impressive and really speaks to the dedication of your team. Can you talk about how the pharmacy program has grown and how you identify when it’s time to bring on additional support?  

David Choi 
Initially, we started small, with 1 pharmacist, and quickly needed to expand to meet the demand. Fee-for-service models primarily use prescription volume to justify positions, and that can be challenging, as it doesn’t capture the full work IBD pharmacists do to optimize patient outcomes. We’ve continued to develop metrics that better capture the full picture and provide us with a clear signal that it’s time to advocate for additional positions. On that note, I am thrilled to say that we just added a third pharmacist to our program!  

Narrator
That’s fantastic! Let’s talk about the impact this integrated model has had on patients. What patient outcomes have been achieved to date?  
 

David Choi 
I already mentioned the 98% success rate of getting patients on their intended therapy.⁴ That one’s worth repeating! But we’ve seen improvement in patient outcomes across the board, both operationally and clinically. For instance, we’ve published data from a single-center, small, retrospective study that showed we’re able to get patients on therapy almost a week faster than external specialty pharmacies.⁵ We have also been able to internally evaluate the impact of a pharmacist-directed treat-to-target strategy, which essentially involves a cadence of frequent touchpoints to ensure therapy adherence and to assess clinical response over time. Providing support to patients at every step is integral to optimizing IBD care.

Narrator 
These outcomes are really encouraging. With the dynamic nature of IBD care, education must play an integral role. What are some of the resources or tools you use to keep the team up to speed? 

David Choi 
I’m really excited to answer this question about ongoing education because currently, there’s a lack of any kind of formalized training for IBD pharmacists. There is a lot of learning on the job, reading guidelines, and just kind of figuring it out as you go. This can prolong the time it takes for pharmacists to feel comfortable and confident in helping to manage IBD patients. 

To help solve this issue, we have instituted monthly meetings and developed programs to accelerate and improve the onboarding process. The IBD Pharmacist Network, for example, provides a peer-to-peer platform where IBD pharmacists can learn from each other and share best practices. We also partner with the Crohn’s & Colitis Foundation and the Advances in Inflammatory Bowel Diseases organization to provide unique educational opportunities that support pharmacists’ education and professional growth. 

Narrator 
That’s excellent. For listeners who might be considering integrating pharmacists into the GI programs, what best practices would you recommend? 

David Choi 
The good news for those IBD centers that are considering pharmacy integration is that they don’t have to reinvent the wheel! Any GI department can emulate different programs that are already out there. 

Regardless of the way in which an IBD center approaches integration, one of the first items on any checklist should be to develop clear job responsibilities for the pharmacy role. Leadership can do this by identifying where they intend pharmacists to have the biggest impact. Typically, that can include areas such as patient education, therapy access and initiation, ongoing monitoring and therapeutic assessment, specialist referrals, and just general overall support throughout the care continuum. 

Another important aspect is establishing operational and clinical workflows. How does leadership envision the team working together to provide efficient coordination and communication? That collaboration between pharmacists and gastroenterologists, APPs, and other specialists should ultimately support high-quality care and predictable outcomes. Variability, delays, redundancy, and confusion, these things can get in the way when workflows aren’t clearly outlined. So, it’s important to have standardized processes and consistent communication in place so we can put our focus on the patient. 

Lastly, you want to establish key performance indicators. Those data provide powerful proof of the value of pharmacist involvement and can help justify additional positions, ensuring the team has the resources needed to drive better outcomes for patients living with IBD. 

Narrator
That is wonderful advice, David. Thank you for sharing your experiences and insights today. Your team’s work is truly inspiring, and I know our listeners will take away valuable ideas for integrating pharmacists into their own GI programs. 

If you enjoyed this episode, be sure to visit our IBD TalkTract homepage to explore more episodes! Also, check out the episode on the integration of advanced practice providers into IBD care at the University of Chicago, featuring David’s colleague, Marita Kametas. Thank you for listening! Together, we can help improve care for patients with IBD.

References: 

1. Ye Y, Manne S, Treem WR, Bennett D. Prevalence of inflammatory bowel disease in pediatric and adult populations: recent estimates from large national databases in the United States, 2007-2016. Inflamm Bowel Dis. 2020;26(4):619-625. doi:10.1093/ibd/izz182 2. IBD facts and stats. Centers for Disease Control and Prevention. June 21, 2024. Accessed April 16, 2025. https://www.cdc.gov/inflammatory-bowel-disease/php/facts-stats/index.html 3. Bhat S, Lyu R, Agarwal M, et al. Defining the roles of inflammatory bowel disease clinical pharmacists in the United States: a systematic review and national RAND/UCLA consensus. Inflamm Bowel Dis. 2024;30(6):950-959. doi: 10.1093/ibd/izad143 4. Choi DK, Rubin DT, Puangampai A, Lach M. Role and impact of a clinical pharmacy team at an Inflammatory Bowel Disease Center. Crohns Colitis 360. 2023;5(2):otad018. doi: 10.1093/crocol/otad018 5. Choi D, Rubin DT, Man B. Impact of a health-system specialty pharmacy on time to upadacitinib initiation. Am J Health Syst Pharm. 2024;81(19):e594-e600. doi: 10.1093/ajhp/zxae123

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