CHS Digestive Health (Atrium Health) and Baylor College of Medicine Charlotte, NC
Elyse R. Thakur, PhD1, Lindsey Martin, PhD2, Ashley Helm, MA3, Maria Jarbrink-Sehgal, MD, PhD3, Mark Kunik, MD, MPH3, Jeffrey Lackner, PsyD4, Lilian Dindo, PhD5, Tracey Smith, PhD3, Johanna Chan, MD5, Hashem El-Serag, MD, MPH5; 1CHS Digestive Health (Atrium Health) and Baylor College of Medicine, Charlotte, NC; 2National Institute of Environmental Health Sciences, Durham, NC; 3Michael E. DeBakey VA Medical Center, Houston, TX; 4University at Buffalo, Buffalo, NY; 5Baylor College of Medicine, Houston, TX
Introduction: Best practice guidelines (NICE, 2008) recommend behavioral treatments for irritable bowel syndrome (IBS) refractory to conventional medical care. Notwithstanding their empirical support (Black, Thakur et al., 2020), access and service provision issues are implementation barriers. One way to enhance referrals is through the development of educational resources. To address this gap, we sought to better understand key stakeholder perceptions of behavioral medicine to inform the development of a “referral toolkit.” Methods: In this qualitative formative evaluation, we conducted in-depth, semi structured interviews with patients, medical and behavioral health providers from a Veterans Affairs medical center (VAMC, n=12, n=5, and n=9, respectively) and an academic medical center (AMC, n=12, n= 9, and n=3, respectively). We assessed attitudes, perceptions, experience and knowledge of behavioral interventions. In addition, providers were asked about patient-provider communication, candidates for care, referral procedures, and feasibility of behavioral medicine services in GI. We used rapid qualitative analysis to identify preliminary themes, which informed the development of the referral toolkit. Results: Patients were willing to try behavioral medicine treatments; however, barriers included schedule and location (VAMC), and timing, travel distance, cost, and transportation (AMC). Additional themes guided the organization of the referral toolkit. Medical providers were interested in learning about behavioral medicine interventions and desired decision support tools to help identify candidates. Providers across sites suggested that it was important to educate patients about IBS-focused behavioral medicine treatments, which aligned with patient’s questions for providers about triggers for IBS and treatment options. Medical and behavioral health providers (VAMC) and medical providers (AMC), suggested that the referral process should include a face-to-face introduction (patient to behavioral medicine specialist) and consult. Providers agreed that the electronic health record should be central to monitoring and tracking referrals. Discussion: Qualitative methods examining key stakeholder’s perspectives and experiences are critical when developing referral resources. Future work should focus on evaluating the feasibility, acceptability, and potential effectiveness of our referral toolkit.
Funding: VA SC MIRECC.
Disclosures: Elyse Thakur indicated no relevant financial relationships. Lindsey Martin indicated no relevant financial relationships. Ashley Helm indicated no relevant financial relationships. Maria Jarbrink-Sehgal indicated no relevant financial relationships. Mark Kunik indicated no relevant financial relationships. Jeffrey Lackner indicated no relevant financial relationships. Lilian Dindo indicated no relevant financial relationships. Tracey Smith indicated no relevant financial relationships. Johanna Chan indicated no relevant financial relationships. Hashem El-Serag indicated no relevant financial relationships.