Assessing attitudes, access, barriers, and facilitators to multidisciplinary care in pediatric inflammatory bowel disease.

OBJECTIVE

Multidisciplinary care is recommended for pediatric inflammatory bowel disease (IBD). This study aims to describe provider attitudes, barriers, and facilitators regarding multidisciplinary care in pediatric IBD, and explore associations between multidisciplinary care access and center-level factors.

METHODS

This is a cross-sectional survey of pediatric gastrointestinal (GI) providers at centers registered with the ImproveCareNow (ICN) Learning Health System in the United States. Participants completed the survey via REDCap. Respondents provided demographic information and answered questions regarding their center's access and approach to multidisciplinary IBD care. Data were analyzed using descriptive statistics, chi-squared, and Fisher's exact tests.

RESULTS

Sixty-nine providers across 55 ICN centers were included. All participants felt multidisciplinary care was beneficial and 80% felt patients/families desired this care. Participants endorsed barriers including lack of support from institutional leadership (39%), limited access to providers (39%), and inadequate numbers of providers (35%). The most common team members were nurses (94%), dietitians (92%), social workers (67%), and nurse practitioners/physician assistants (67%). Multidisciplinary teams commonly provided care via telehealth (94%), standardized educational materials (84%), multidisciplinary visits (69%), new diagnosis education (65%), and transition programs (61%). Access to nurse practitioners/physician assistants, quality improvement specialists, multidisciplinary visits, and support groups were associated with increasing center size (p < 0.05).

CONCLUSION

Pediatric GI providers have positive attitudes regarding IBD multidisciplinary care and perceive this care as important and desired. Access and barriers are variable among US ICN centers. Future work should seek to further understand and address barriers and evaluate the benefits of multidisciplinary care in pediatric IBD.