Pancreas · 2026
Care Gaps in Pancreatic Enzyme Replacement Therapy: A Survey of Real-World Practice Patterns in the United States.
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Chong Bradford, Whitlock Jennifer, Patel Kalpesh, Dylla Douglas, Noonan Alicia J, Shen Eric, Garcia-Horton Viviana, Yang Min, Edwards Marie Louise, Barkin Jodie A
Аннотация
OBJECTIVES: To describe real-world clinical practice patterns among U.S.-based healthcare providers (HCPs) regarding the use of pancreatic enzyme replacement therapy (PERT) in the management of exocrine pancreatic insufficiency (EPI).
METHODS: A cross-sectional, online, double-blinded survey was conducted among a panel of HCPs, including physicians, nurse practitioners, and physician assistants, with ≥3 years of experience treating EPI and recent PERT prescribing activity. The survey collected de-identified data on HCP demographics, aggregated patient characteristics, PERT prescribing patterns, and follow-up practices. Descriptive statistics were used to summarize the data.
RESULTS: Of the 354 HCPs screened, 250 completed the survey. Participants were mainly physicians (88%), predominantly in private practice (69%), with an average of 20 years of clinical experience. Initial PERT doses prescribed were <30,000 lipase units (LU) per meal (12%), 30,000-59,000 LU/meal (58%), and ≥60,000 LU/meal (14%). Only 60% of HCPs included snack dosing instructions, and follow-up for dose titration occurred most frequently at one month post-initiation (60%). PERT underdosing and omitted dosing instructions for snacks were common.
CONCLUSION: Real-world PERT prescribing for EPI in the U.S. frequently falls short of guideline-recommended dosing and follow-up is often delayed. Providing patients with instructions snack dosing and early reassessment represent gaps in EPI care, underscoring the importance of HCP training and education to optimize outcomes of EPI treatment.
METHODS: A cross-sectional, online, double-blinded survey was conducted among a panel of HCPs, including physicians, nurse practitioners, and physician assistants, with ≥3 years of experience treating EPI and recent PERT prescribing activity. The survey collected de-identified data on HCP demographics, aggregated patient characteristics, PERT prescribing patterns, and follow-up practices. Descriptive statistics were used to summarize the data.
RESULTS: Of the 354 HCPs screened, 250 completed the survey. Participants were mainly physicians (88%), predominantly in private practice (69%), with an average of 20 years of clinical experience. Initial PERT doses prescribed were <30,000 lipase units (LU) per meal (12%), 30,000-59,000 LU/meal (58%), and ≥60,000 LU/meal (14%). Only 60% of HCPs included snack dosing instructions, and follow-up for dose titration occurred most frequently at one month post-initiation (60%). PERT underdosing and omitted dosing instructions for snacks were common.
CONCLUSION: Real-world PERT prescribing for EPI in the U.S. frequently falls short of guideline-recommended dosing and follow-up is often delayed. Providing patients with instructions snack dosing and early reassessment represent gaps in EPI care, underscoring the importance of HCP training and education to optimize outcomes of EPI treatment.