P0440 - Perceptions Towards Screening for Barrett’s Esophagus in Primary Care Clinic via Open-Access Endoscopy

Junseo B. Lee, MD¹, Valeria Martinez Lebron, MD¹, Julia Boland, MD¹, Eliseo Acevedo-Diaz, MPH¹, Marie L. Borum, MD, EdD, MPH², Samuel A. Schueler, MD^3
1George Washington University School of Medicine and Health Sciences, Washington, DC; ²George Washington University Medical Center, Washington, DC; ³George Washington University Hospital, Washington, DC

Introduction: Guidelines recommend screening for Barrett’s esophagus (BE) via esophagogastroduodenoscopy (EGD) for patients with chronic gastroesophageal reflux disease (GERD) symptoms and three or more of the following risk factors: age greater than 50 years, male sex, white race, obesity, tobacco use, or family history of BE or esophageal adenocarcinoma. Providers may refer patients for open-access (OA) endoscopy without gastroenterology consultation and frequently use this for colorectal cancer (CRC) screening. However, OA endoscopy bypasses the opportunity for a gastroenterologist to assess for BE risk factors, particularly in patients referred for colonoscopy. We sought to assess knowledge, interest, and perceptions of internal medicine (IM) residents and attending physicians regarding screening for BE in clinic and referral for EGD (when indicated) for patients being assessed for OA colonoscopy.

Methods: We sent out a 7-question online survey using a Likert-type scale to residents and attending physicians (Image 1). We analyzed demographics, career stage, knowledge of BE guidelines, and perceptions towards interest and feasibility of performing BE screening and EGD referrals in patients already being assessed for OA colonoscopy referrals, and the likelihood of referrals if provided with an instructive dot-phrase. Resident and attending physician responses were compared (Table 1).

Results: A total of 44 survey responses were obtained from 20 primary care attendings and 24 IM residents. 27/44 (61.3%) responded agree/strongly-agree regarding knowledge of current BE screening guidelines. 38/44 (86.4%) and 26/44 (59%) responded agree/strongly-agree for both interest and feasibility, respectively, in assessing patients for EGD for BE screening in patients being referred for OA colonoscopy. 43/44 (97.7%) responded agree/strongly-agree when asked if a dot-phrase would make them more likely to refer patients for EGD for BE screening (Table 1). When attending physicians were compared to residents, there were no significant differences in gender, race, or responses to any of the survey questions (Table 1).

Discussion: The majority (97.7%) of residents and attending physicians felt a dot phrase on indications for BE screening would make them more likely to place EGD referrals in patients being considered for OA colonoscopy. This, in combination with high baseline confidence on current BE screening guidelines, suggests that a dot phrase may increase EGD referrals for BE screening.




Disclosures:


Junseo B. Lee, MD¹, Valeria Martinez Lebron, MD¹, Julia Boland, MD¹, Eliseo Acevedo-Diaz, MPH¹, Marie L. Borum, MD, EdD, MPH², Samuel A. Schueler, MD³. P0440 - Perceptions Towards Screening for Barrett’s Esophagus in Primary Care Clinic via Open-Access Endoscopy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.