Knowledge Gaps and the Care of Children with IBD

Adult and pediatric onset Inflammatory Bowel disease (IBD) are complicated, multifaceted conditions with an expanding array of treatments. Complications outside the traditional scope of the disease arise with disease progression and as a result of certain treatments. However, complications such as uveitis, skin cancer, and infection can be mitigated with proper preventative service measures. Yet, previous studies have identified that patients with IBD are not receiving the appropriate preventive care given these concerns. We argue a lack of primary care knowledge regarding IBD and its management, is one component contributing to this deficit in preventative service administration, specifically in pediatric onset IBD. This study uses 15-question survey distributed to primary care physicians that care for children within the referral area of the Pediatric Gastroenterology Clinic at the Palmetto Health USC Medical Group to determine if a lack of knowledge regarding IBD and its management exists in the Midlands of South Carolina. The survey was designed as a multiple-choice assessment to determine baseline knowledge regarding pediatric onset IBD and associated preventative care standards. 386 surveys were distributed with a return of 50 surveys. Surveys were uniformly graded and results from the primary care physicians were compared to a group of hospital internists using a Welch sample T test. Primary care physicians within the referral area scored significantly lower than the internists, with a P value of 0.026. An analysis of covariance eliminating provider age, years in practice, and number of patients seen with IBD confirmed this statistical difference. We concluded that there is a lack of knowledge among primary care physicians in the Midlands of South Carolina regarding pediatric onset IBD. Future work aims to demonstrate how this lack of knowledge affects preventative service administration in the Midlands of South Carolina.