Patient education to increase behavioral treatment referrals for rumination syndrome.

Abstract

Objective: Rumination syndrome (RS) is a disorder of gut-brain interaction (DGBI) for which evidence-based intervention includes behavioral treatment (BT). However, youth with DGBIs, including RS, face numerous barriers to accessing behavioral health care. This brief report describes the initiation of a quality improvement project that (a) assessed RS education and referral practices within our gastroenterology (GI) division, (b) developed patient education materials about RS and BT, and (c) implemented a process to monitor the educational initiative's impact on BT referrals. Method: Baseline referral and education practices were assessed by a provider survey. The authors developed a patient handout, a two-part video, and a provider documentation phrase about RS and BT to be used in the electronic medical record (EMR). A newly developed EMR-based registry tracks patients diagnosed with RS, use of education materials, and referrals to BT. A follow-up survey assessed providers' knowledge and use of new education tools. Results: Data from 39 GI providers indicated multiple BT referral barriers. Providers expressed confidence in educating patients/families about RS but endorsed limited time for comprehensive education. In response, we developed and disseminated educational materials about RS and BT. Follow-up data from 25 providers indicated general awareness of education materials, with 50% of providers disseminating RS materials to patients/families. After this educational intervention, BT referrals increased from 50.8% to 61.3% of patients diagnosed with RS. Conclusions: Development and distribution of RS educational materials increased referrals to BT. Providing standard educational materials may decrease variability in care and increase the acceptability of appropriate therapy for RS and, potentially, other DGBIs. Implications for Impact StatementYouth with rumination syndrome (RS) may not be referred for evidence-based behavioral treatment (BT) in a timely manner. Medical providers also have limited time and resources to fully educate patients and families about treatment. This study suggests that providing consistent education materials to medical providers, patients, and families increases how many newly diagnosed patients with RS are referred to BT.