Multidisciplinary Care for Refractory Pediatric Functional Abdominal Pain Decreases Emergency and Inpatient Utilization

Chu, Andrew S; Torres, Laura; Kao, Grace; Gilbert, C. Mitchell; Monico, Evelyn C.; Chumpitazi, Bruno P.

doi:10.1097/mpg.0000000000003305

Cited by 5 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…increases functioning (Beinvogl et al, 2019), and reduces acute health care utilization (Chu et al, 2022). The results of this study align with research indicating high MPS with IC in primary care and a preference for embedded BH services (Asarnow et al, 2015).…”

Section: Discussionsupporting

confidence: 83%

“…Medical providers expressed higher satisfaction with embedded versus colocated IC and a desire to expand IC services, which may relate to medical providers’ limited time and experience to address complex psychosocial issues during medical visits. Preference for embedded care is consistent with best practice recommendations to incorporate psychogastroenterology into management of digestive disorders (Keefer et al, 2018) and findings that multidisciplinary care of pediatric patients with functional GI disorders reduces pain, increases functioning (Beinvogl et al, 2019), and reduces acute health care utilization (Chu et al, 2022). The results of this study align with research indicating high MPS with IC in primary care and a preference for embedded BH services (Asarnow et al, 2015).…”

Section: Discussionsupporting

confidence: 53%

See 1 more Smart Citation

Medical provider satisfaction with integrated care in a pediatric gastroenterology clinic.

Nicolotti¹,

Koehler²,

Quinones³

et al. 2023

Families, Systems, & Health

View full text Add to dashboard Cite

Introduction: Benefits of behavioral health (BH) integrated care (IC) in pediatric primary care have been demonstrated (Asarnow et al., 2015). Pediatric subspecialty care treats patients with high levels of medical and psychosocial vulnerability and complexity (Samsel et al., 2017), underscoring the need for increased IC. Medical provider satisfaction (MPS) with IC is highly relevant for the utilization and expansion of these services. The purpose of this preliminary study was to examine MPS related to BH IC services in a pediatric gastroenterology clinic. Method: Eight pediatric gastroenterology providers working in an outpatient clinic completed a 32-item survey (adapted from Corso et al., 2016) assessing their satisfaction with integrated BH care services. Descriptive statistics were utilized to examine and summarize provider satisfaction data. Results: Pediatric gastroenterology medical providers reported high levels of satisfaction with existing IC services and a preference for embedded versus colocated IC. They perceived provider-related and clinical benefits of IC, felt that addressing BH issues is important, and believed IC is a valued service. Medical providers expressed that they wanted expanded IC services, including an embedded psychologist at more locations, BH screenings for younger patients, and an electronic psychosocial screening process. Discussion: The results of this study align with research findings regarding high medical provider satisfaction with IC in primary care and a preference for embedded BH services (Asarnow et al., 2015). While this preliminary study is small in scale, it is an important initial step to better understand MPS with IC in pediatric subspecialty care.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 53%

Medical provider satisfaction with integrated care in a pediatric gastroenterology clinic.

Nicolotti¹,

Koehler²,

Quinones³

et al. 2023

Families, Systems, & Health

View full text Add to dashboard Cite

show abstract

“…Moreover, an integrative team approach is safe, feasible, and more cost-effective for families [6 ▪▪ ]. When children and adolescents with refractory FAPD were treated with outpatient multidisciplinary team appointments they had reduced emergency room visits and fewer hospitalizations [7 ▪▪ ].…”

Section: Treatmentmentioning

confidence: 99%

Psychological treatment for pediatric functional abdominal pain disorders

Puckett-Perez

Gresl

2022

Current Opinion in Pediatrics

View full text Add to dashboard Cite

Purpose of reviewThe purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for primary care providers who are the “front line” of treatment for pediatric FAPD.Recent findingsPositive diagnosis, pain education, and access to multidisciplinary care improve outcomes for FAPD patients. Cognitive behavioral therapy (CBT) and hypnosis continue to have the strongest evidence in psychological treatments, but educational interventions and other nonpharmacological approaches show promise as well. There are innovative programs that combine these tools into group or internet-based treatments to expand access to care. Additionally, nonpharmacological tools, including neurostimulation and virtual reality programs, are increasing in popularity.SummaryFAPD is prevalent across pediatric practices, yet there is no standard medical or dietary approach, and there are many barriers to diagnosis and treatment. It is important for patients to have positive encounters around diagnosis and education, access to multidisciplinary care, and integrated psychological support. Consistently, studies show that psychology continues to be a vital component of care. This review discusses supported uses of psychology, innovative programming for increasing access to care, and how primary care providers can incorporate lessons learned from psychology in FAPD care.Video Abstracthttp://links.lww.com/MOP/A67.

show abstract

The Approach to the Management of a Child with Chronic Abdominal Pain

Farrell,

Farrell

2024

Curr Treat Options Peds

View full text Add to dashboard Cite

Purpose of Review Abdominal pain occurs frequently in children; chronic abdominal pain affects about 15% of children. There is always an initial concern for serious organic medical conditions; these can be eliminated with careful history and physical examination, especially looking for “red flags.” These children are often subjected to numerous invasive and noninvasive tests; excessive testing should be avoided. There is no evidence extensive testing improves patient outcome or satisfaction. Recent guidelines recommend celiac serology and fecal calprotectin/lactoferrin as the optimal screening tests. Anxiety is often a co-morbidity; the continued testing and lack of explanation exacerbate the symptoms and cause more dysfunction. Recent Findings Ongoing research suggests chronic abdominal pain is a complex interaction of genetics, environmental factors including diet, changes in the microbiome, previous life events, and stresses. The gut-brain axis is now more accurately described as the microbiome-gut-brain axis. Many disturbances have been reported but it remains unclear which are causative versus reactive. Therapeutic interventions have targeted one or more of the components but rarely in a coordinated manner. A positive diagnosis and explanation of pathophysiology are crucial first steps. A holistic approach that focuses on restoration of functioning and well-being is the best approach. A non-pharmacologic approach is the favored initial therapy; many children improve with counseling and assurance that there are no serious organic disorders. A trusting relationship with child and family is an integral part of the treatment plan. Summary Pediatric chronic abdominal pain is commonly encountered in practice. Serious conditions can be eliminated by determining whether any of the so-called red flags are present and judicious testing. High quality evidence is lacking for many proposed treatments. Data interpretation is confounded by a high placebo response rate, even when the placebo is unblinded. The current best evidence is for non-pharmacologic treatments including cognitive behavioral therapy and hypnosis. Neuromodulation is a new, promising intervention.

show abstract

Multidisciplinary Care for Refractory Pediatric Functional Abdominal Pain Decreases Emergency and Inpatient Utilization

Cited by 5 publications

References 21 publications

Medical provider satisfaction with integrated care in a pediatric gastroenterology clinic.

Medical provider satisfaction with integrated care in a pediatric gastroenterology clinic.

Psychological treatment for pediatric functional abdominal pain disorders

The Approach to the Management of a Child with Chronic Abdominal Pain

Contact Info

Product

Resources

About