EP566 - Variability in Knowledge, Education Delivery, and Access to Care Among Adult Inflammatory Bowel Disease (IBD) Patients

ePoster Presenter(s)

• CA

  Chandler A. Annesi, MD (she/her/hers)

  General Surgery Resident
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  Disclosure information not submitted.

Author(s)

• 

  Gianina C. Hernandez-Marquez, MD (she/her/hers)

  Postdoctoral Research Fellow
  UNIVERSITY OF ALABAMA AT BIRMINGHAM
  University of Alabama at Birmingham
  Birmingham, AL, United States

  Disclosure information not submitted.

Author(s)

• 

  Alizeh Abbas, MD (she/her/hers)

  General Surgery Resident
  University of Alabama at Birmingham
  University of Alabama at Birmingham (UAB)
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• 

  Wendelyn M. Oslock, MD, MBA (she/her/hers)

  Surgery Resident
  University of Alabama Birmingham
  University of Alabama Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• AH

  Alfonsus Adrian H. Harsono, MD, MSPH

  Postdoctoral Fellow
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• GN

  Gurudatta Naik, MPH

  Scientist 1
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• IH

  Ivan I. Herbey, Sr., MD

  Analyst
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• KK

  Keri M. Kemp, PhD

  Assistant Professor
  UAB Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• JP

  Jennifer Pollock, PhD

  Endowed Professor
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• KR

  Kirk B. Russ, MD

  Assistant Professor
  Division of Gastroenterology & Hepatology, UAB Department of Medicine
  BIRMINGHAM, Alabama, United States

  Disclosure information not submitted.
• 

  Robert Hollis, MD, MSPH

  Assistant Professor
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  Disclosure information not submitted.

Senior Author(s)

• 

  Daniel I. Chu, MD, MSPH (he/him/his)

  Professor and Division Director
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Education and timely access to care play a vital role in the early diagnosis and proper management of inflammatory bowel disease (IBD). Nevertheless, current practices fail to deliver effective education or strategies to minimize barriers to care. We therefore aimed to identify modifiable aspects of IBD care in these components from the perspective of adult IBD patients.

Methods/Interventions: Semi-structured interview guides for adult IBD patients who were ≥18 years old and diagnosed no more than five years ago, were created using Health Literacy and Outcomes Framework for this qualitative study. Questions and probes addressed knowledge about IBD, education delivery, access to care, and health literate practices used in the IBD population across patient, provider, and system levels. Interviews were recorded, transcribed, and analyzed using iterative content analysis in NVivo 14.

Results/Outcomes: Nine adult IBD patients were recruited and interviewed. The average age of participants was 39 ± 19.4 years, 8 (88.9%) were female, and 2 (22.2%) identified as African American/Black. The first major theme that emerged was the mixed knowledge about IBD prior to diagnosis. Seven (77.8%) reported never having heard of the disease, two had family members with gastrointestinal diseases, and one had a medical background. The second major theme reflected the significant variability in delivery of education which could occur in verbal form, written form, and/or visual form with delivery by physicians, nurses, and/or nutritionists. Effective communication between patients and providers was deemed highly important. The third major theme focused on access to care. Adult IBD patients identified both barriers and enabling factors. Among the barriers, the following were reported: a) lack of insurance coverage, b) inaccessible specialists, c) long distances, d) mistrust in the system, and e) delays in diagnosis. Enabling factors included: a) quick referrals, b) multispecialist collaboration, c) use of patient portal, d) multiple providers in one place, and e) employer's insurance. Finally, a fourth theme emerged that focused on areas of improvement. These included: a) needing more guidance on diet adjustments, b) having alternative bowel prep options, and c) getting connected with other IBD patients. Figure 1 shows the themes and subthemes identified in this study.

Conclusion/Discussion: Knowledge, education, and access influence high-quality care for adult IBD patients. Recognizing, addressing, and optimizing these domains is critical to improving care for adult individuals with IBD.

Themes and sub-themes identified across the journey to get medical care in adult IBD patients.
The themes and their subthemes are indicated by the same color. *Barriers to care have a darker orange and enabler factors a lighter one.