A realist evaluation of an integrated care pathway for inflammatory bowel disease in the North East of England

A mixed-methods non-participant evaluation of an integrated care pathway for adult inflammatory bowel disease patients in a North East of England health economy was undertaken utilising a realist evaluation framework. The evaluation commenced at an early stage in the pathway’s life in October 2009 and closed two and a half years later in March 2012. The evaluation identified internal and external enablers and inhibitors to the pathway, primarily in the design and implementation phases as opposed to the operational phase. Inferences were made to contemporaneous evaluations of integrated care projects which served to validate this evaluation and identify the additional value of the evaluation to the health services research field. Contextual enabling and inhibiting factors were identified along with their associated mechanisms and actual or potential outcomes. An additional pilot project identified the scope for, and potential nature of, a role for community pharmacy in the management of adult IBD patients.