University of North Carolina Charlotte, NC, United States
Elyse Thakur, PhD1, Baha Moshiree, MD2, Mackenzie Jarvis, PA-C1, Jason Baker, PhD1 1Carolinas Medical Center, Charlotte, NC; 2Atrium Health, Charlotte, NC
Introduction: Brain-gut psychotherapies are efficacious, resulting in recognition of integrated GI psychology (GI-PSY) services. However, the COVID-19 (C-19) pandemic changed the healthcare landscape. Aim of this study was to characterize referral patterns and baseline health status during the peak of the C-19 pandemic in a community-based GI-PSY program.
Methods: Retrospective analysis of adults who had a baseline assessment for GI-PSY services in a community GI center during the C-19 peak in North Carolina (11/2020-2/2021). Demographics, referring provider specialty (Physician [PN], Advanced Practice Provider [APP]), and self-reported GI symptoms were obtained. Participants completed the Generalized Anxiety Disorder (GAD-7) scale (Range: 0-21; higher scores = more severe anxiety), PHQ-9 (Range: 0-27; higher scores = more severe depression), PHQ-15 (Range: 0-30; higher scores = greater levels of somatization), and the PROMIS Global-10 (assesses physical (PH) and mental domains (MH) of quality of life via a T-score distribution). Comparison between PN vs. APP was examined on these measures. Statistical analyses included:t-test, chi-square, and linear regression models. P-values < 0.05 are considered statistically significant.
Results: 30 participants (mean age = 38.3±16.9: Range: 18-75; 60.0% female; 80% functional or motility referrals) were included. Referral provider distribution: PN (64%) vs. APP (36%). The mean Global-10 MH was statistically significance for APP vs. PN referrals: 46.7 vs. 35.1, p = 0.02. A significant trend was found for PHQ-15 scores for APP vs. PN: 13.9 vs. 9.9, p =0.09. No significant differences related to self-reported GI symptoms for PN vs. APP in GI-PSY referrals. Linear regression models using health outcomes as the dependent variable controlling for age, sex, and referral provider depicted: GAD-7 (females [p=0.02] and PN (p = 0.05) were associated with greater anxiety; PHQ-9 (PN [p=0.02] for higher levels of depressive symptoms; PHQ-15 (females [p=0.004] and PN [p=0.05] for greater levels of somatic symptoms); MH (PN [p=0.10] for lower quality of life).
Discussion: During the NC C-19 peak, GI-PSY patients referred by PN vs. APP differed on baseline psychological status. GI-PSY female patients referred by PNs had more severe anxiety, depression, somatization, and lower levels of MH-related quality of life. Further investigation is warranted to identify factors associated with GI-PSY referral patterns among providers.
Elyse Thakur indicated no relevant financial relationships.
Baha Moshiree indicated no relevant financial relationships.
Mackenzie Jarvis indicated no relevant financial relationships.
Jason Baker indicated no relevant financial relationships.
Elyse Thakur, PhD1, Baha Moshiree, MD2, Mackenzie Jarvis, PA-C1, Jason Baker, PhD1. P2475 - The Impact of COVID-19 on the Development of a Newly Integrated GI Psychology Program in a Community-Based Hospital Setting, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.