Barriers for clinic follow-up in patients with symptoms from chronic pancreatitis: A telephone survey and descriptive analysis

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Gastroenterol


Introduction: Chronic pancreatitis (CP) is a complex disease that leads to structural damage and dysfunction and can lead to symptoms such as abdominal pain, nausea, vomiting, diarrhea, and weight loss. CP can create a burden on the healthcare system, especially due to recurrent ED visits. Appropriate follow-up may help to decrease symptoms and improve quality of life. Our study assesses barriers to follow-up after ED visits for CP complaints. Methods: A telephone survey was conducted from patients with CP who present to a tertiary health care system in Detroit with symptoms from CP. All living patients 18 years and older who presented to the ED for CP symptoms were included. Data on demographics and clinic follow-up were extracted by manual chart review. After obtaining informed consent a telephone survey was conducted to obtain data on CP symptoms, severity, follow-up rates, and barriers to follow-up. The social deprivation index (SDI) score was used to compare the socioeconomic status (SES) of patients. Results: A total of 196 patients were screened but only 42 participated of which the mean age was 50.4, 22 (52.4%) were men and 23 (54.8%) were white. 25 (59.5%) developed CP due to alcohol. Statistical analysis showed that CP patients given narcotics in the ED were more likely to follow-up in the clinic than those who did not [95% CI 2.69 (1.21-5.99)]. There was no statistically significant difference in age, gender, race, county of residence, SES, alcohol use, smoking, CP cause, type of follow-up arranged, and abdominal pain frequency and severity among all patients who participated in the survey. Barriers mentioned by patients were financial issues, lack of insurance, lack of transportation, the knowledge that they need to follow-up, insight about their disease, and worrying about contracting COVID-19. Conclusion: This telephone study identified factors that limit follow-up from the ED for patients presenting with CP-related symptoms. Although there was a high drop-out rate the commonly reported factors can be addressed and corrected in the ED. This intervention coupled with appropriate follow-up may lead to improved outcomes and a decrease in ED visits for these patients. Further studies are needed to support this hypothesis.

PubMed ID

Not assigned.





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