# Optimizing Multispecialty Preventive Care: Referral Patterns, Adherence, and Remission in Inflammatory Bowel Disease

## TL;DR

This study shows that following dermatology referrals for IBD patients improves disease outcomes and suggests a need for better referral systems in related specialties.

## Contribution

The study identifies a link between preventive dermatology referrals and improved IBD remission, proposing a model for standardized multidisciplinary care.

## Key findings

- Adherence to dermatology and ophthalmology referrals was significantly associated with IBD remission.
- Dermatology referrals showed higher adherence and were more preventive compared to ophthalmology referrals.
- Ophthalmology referrals were often reactive, linked to active symptoms and complications.

## Abstract

Background

Extraintestinal manifestations of inflammatory bowel disease (IBD) frequently involve the skin and eyes. Although current management guidelines emphasize multidisciplinary surveillance, referral practices to dermatology and ophthalmology remain inconsistent across specialties, potentially affecting disease control and patient outcomes.

Methods

A retrospective chart review was conducted at the George Washington University Hospital, an urban tertiary academic medical center in Washington, D.C., USA, between August 2023 and August 2025. Adult patients (≥18 years) with Crohn’s disease, ulcerative colitis, or indeterminate colitis seen in the gastroenterology clinic were identified. Patients with active referrals to dermatology or ophthalmology were included, while those without documented referrals or with incomplete medical records were excluded. Referral patterns, adherence to specialty appointments, and remission status were analyzed. A total of 102 dermatology and ophthalmology referrals among 586 patients with IBD were evaluated.

Results

Adherence to both dermatology and ophthalmology referrals was significantly associated with disease remission (p < 0.05). Dermatology referrals demonstrated higher adherence rates and were more frequently preventive in nature, whereas ophthalmology referrals were more commonly initiated in response to active symptoms and disease complications.

Conclusions

Preventive dermatologic surveillance in patients with IBD is associated with improved adherence and favorable disease outcomes. This proactive model may inform the development of standardized referral frameworks across IBD-related specialties, particularly ophthalmology, to strengthen multidisciplinary care and optimize long-term patient outcomes.