Creation of an Inflammatory Bowel Disease Referral Pathway for Identifying Patients Who Would Benefit From Inflammatory Bowel Disease Specialist Consultation

Inflammatory Bowel Diseases · 17 authors, 17 centres

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TL;DR

A scoping literature review and an 11-member expert panel using the RAND/UCLA Appropriateness Method developed a referral care pathway for identifying IBD patients who would benefit from specialist consultation, resulting in 13 major and 15 minor criteria requiring 1 major or 2 or more minor criteria to prompt consultation.

Full summary

482 CHARS

A scoping literature review screened 280 articles and selected 47 for extraction, identifying 43 clinical features potentially predictive of the need for referral from a GI office to an IBD specialist. Of the 43 features assessed, 13 were included as major criteria and 15 as minor criteria, with the panel agreeing that 1 major or 2 or more minor criteria should be required to consider consultation. Future research is needed to validate the criteria and assess real-world impact.

STUDY TYPE

guidelines

SPECIALTY

gastroenterology

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10393070

Creation of an Inflammatory Bowel Disease Referral Pathway for Identifying Patients Who Would Benefit From Inflammatory Bowel Disease Specialist Consultation

Inflammatory Bowel Diseases

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ABSTRACT

Abstract Background Recommendations regarding signs and symptoms that should prompt referral of patients with inflammatory bowel disease (IBD) to an IBD specialist for a consultation could serve to improve the quality of care for these patients. Our aim was to develop a consult care pathway consisting of clinical features related to IBD that should prompt appropriate consultation. Methods A scoping literature review was performed to identify clinical features that should prompt consultation with an IBD specialist. A panel of 11 experts was convened over 4 meetings to develop a consult care pathway using the RAND/UCLA Appropriateness Method. Items identified via scoping review were ranked and were divided into major and minor criteria. Additionally, a literature and panel review was conducted assessing potential barriers and facilitators to implementing the consult care pathway. Results Of 43 features assessed, 13 were included in the care pathway as major criteria and 15 were included as minor criteria. Experts agreed that stratification into major criteria and minor criteria was appropriate and that 1 major or 2 or more minor criteria should be required to consider consultation. The greatest barrier to implementation was considered to be organizational resource allocation, while endorsements by national gastroenterology and general medicine societies were considered to be the strongest facilitator. Conclusions This novel referral care pathway identifies key criteria that could be used to triage patients with IBD who would benefit from IBD specialist consultation. Future research will be required to validate these findings and assess the impact of implementing this pathway in routine IBD-related care. Keywords: inflammatory bowel disease, care referral pathway, IBD specialist consultation

CITATION EXPORT

Frank I Scott, Orna Ehrlich, Dallas Wood et al.. Creation of an Inflammatory Bowel Disease Referral Pathway for Identifying Patients Who Would Benefit From Inflammatory Bowel Disease Specialist Consultation. Inflammatory Bowel Diseases. (2022). https://doi.org/10.1093/ibd/izac216

AUTHORS

17 · 17 CENTRES

Frank I Scott, Orna Ehrlich, Dallas Wood, Catherine Viator, Carrie Rains, Lisa DiMartino, Jill McArdle, Gabrielle Adams, Lara Barkoff, Jennifer Caudle, Jianfeng Cheng, Jami Kinnucan, Kimberly Persley, Jennifer Sariego, Samir Shah, Caren Heller, David T Rubin

1 Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
2 Crohn’s & Colitis Foundation, New York, NY, USA
3 RTI International, Research Triangle Park, NC, USA
4 RTI International, Research Triangle Park, NC, USA
5 RTI International, Research Triangle Park, NC, USA
6 RTI International, Research Triangle Park, NC, USA
7 RTI International, Research Triangle Park, NC, USA
8 Southwest Gastroenterology, Albuquerque, NM, USA
9 Albuquerque, NM, USA
10 Department of Family Medicine, Rowan University School of Osteopathic Medicine, Sewell, NJ, USA
11 Everett Clinic, Everett, WA, USA
12 Section of Gastroenterology and Hepatology Mayo Clinic, Jacksonville, FL, USA
13 GI Alliance Gastroenterologist Presbyterian, Dallas, TX, USA
14 Penn Medicine At Home, University of Pennsylvania Health System, Bala Cynwd, PA, USA
15 Division of Gastroenterology, Brown University, Providence, RI, USA
16 Crohn’s & Colitis Foundation, New York, NY, USA
17 Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA