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

## TL;DR

This study explores how pediatric IBD providers in the US view and implement multidisciplinary care, identifying common barriers and team structures.

## Contribution

The study provides insights into provider attitudes and practical barriers to multidisciplinary care in pediatric IBD within a national network.

## Key findings

- Most providers believe multidisciplinary care is beneficial and desired by patients/families.
- Common barriers include lack of institutional support and limited access to providers.
- Larger centers are more likely to have access to multidisciplinary care resources.

## Abstract

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.

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.

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).

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.

Multidisciplinary care is recommended for pediatric patients with inflammatory bowel disease (IBD).Access to multidisciplinary care may vary between centers due to a variety of barriers.

Multidisciplinary care is recommended for pediatric patients with inflammatory bowel disease (IBD).

Access to multidisciplinary care may vary between centers due to a variety of barriers.

Pediatric gastrointestinal providers have positive attitudes toward IBD multidisciplinary care.While most multidisciplinary care teams included nurses, dietitians, social workers, and advanced practice providers, clinical pharmacists and case managers were frequently lacking.The most common barriers to multidisciplinary care in this survey included lack of institutional support and limited access to multidisciplinary providers.

Pediatric gastrointestinal providers have positive attitudes toward IBD multidisciplinary care.

While most multidisciplinary care teams included nurses, dietitians, social workers, and advanced practice providers, clinical pharmacists and case managers were frequently lacking.

The most common barriers to multidisciplinary care in this survey included lack of institutional support and limited access to multidisciplinary providers.