Abstract

A Multidisciplinary Approach to Biopsychosocial Care for Adults With Inflammatory BowelDisease: A Pilot Study

Lee CK1,2, Melmed GY1, Mann A1, Danovitch I1, Hedrick R1, McGovern DPB1, Targan S1, Shih D1, Vasiliauskas E1, IsHak WW3, Feldman E1. Inflamm Bowel Dis. 2018 Jun 15. doi: 10.1093/ibd/izy215. [Epub ahead of print]
 
     

Author information

1 F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California.

2 Center for Crohn's and Colitis, Division of Gastroenterology, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

3 Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California.

Abstract

BACKGROUND: This study reports on the logistics and feasibility of a novel multidisciplinary approach to biopsychosocial care at a tertiary adult inflammatory bowel disease (IBD) center.

METHODS: Consecutive patients referred for a new IBD consultation completed the following self-assessments: the Short Form-12, the Patient Reported Outcome Measurement Information System (PROMIS) Global Health Scale, the World Health Organization Disability Assessment Schedule 2.0, and the PROMIS-29. These measures were scored at the time of appointment check-in by a trained licensed clinical social worker (SW), and those scoring 1.5 standard deviations below the population mean were targeted for SW assessment and intervention at the point of care; patients or providers could also request a SW evaluation even if cutoffs were not met. In this stepped-care model, the SW could refer to same-day on-site psychiatry services or outside interventions and services. In addition, we implemented a 12-month curriculum with a monthly didactic and case-based education seminar for health care providers who interact with patients with IBD.

RESULTS: Between February 2014 and May 2015, 110 patients (53% male; mean age, 42 years) completed a self-assessment. All patients completed their self-assessment within 10 minutes. Of these, 36.4% (40/110) were targeted for SW assessment and intervention. The SW interventions were grouped into 4 categories: psychological education and coping tools for symptom management and emotional wellness (n = 30); psychotherapy referrals (n = 30); financial/governmental programs (n = 11); and psychiatry referrals for consultation and/or medication prescription (n = 21). The educational seminars were highly rated by participating providers.

CONCLUSIONS: A multidisciplinary biopsychosocial approach to adult IBD care is feasible. Education for providers and close coordination across specialties are critical to the success of a multidisciplinary biopsychosocial program.

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