P0437 - Esophageal Expert Development of a Disease-Specific Question Prompt List for Adults With Eosinophilic Esophagitis: A Modified Delphi Study

Sudharshan Achalu, BA¹, Rani Berry, MD¹, Meera Bhargava, MS¹, Albert J. Bredenoord, MD², Joy W. Chang, MD, MS³, Evan S. Dellon, MD, MPH⁴, Gary Falk, MD, MS, FACG⁵, Nielsen Fernandez-Becker, MD, PhD⁶, Ikuo Hirano, MD⁷, Jennifer L. Horsley-Silva, MD⁸, David Leiman, MD, MSHP⁹, Kristle Lee Lynch, MD¹⁰, Kathryn Peterson, MD, MSCI¹¹, Afrin N. Kamal, MD, MS^1
1Stanford University School of Medicine, Redwood City, CA; ²Amsterdam University Medical Center, Amsterdam, Noord-Holland, Netherlands; ³University of Michigan, Ann Arbor, MI; ⁴University of North Carolina School of Medicine, Chapel Hill, NC; ⁵University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; ⁶Stanford University, Redwood City, CA; ⁷Feinberg School of Medicine, Northwestern University, Chicago, IL; ⁸Mayo Clinic Arizona, Phoenix, AZ; ⁹Duke University Medical Center, Durham, NC; ¹⁰University of Pennsylvania, Philadelphia, PA; ¹¹University of Utah School of Medicine, Salt Lake City, UT

Introduction: Question prompt lists (QPLs) are carefully curated collections of disease-specific questions designed to empower patients. They serve as catalysts for increasing patient engagement by prompting them to ask pertinent questions about their disease. Patients with higher engagement are more likely to be active in the management of their care. To date, an EoE-specific QPL has yet to be developed. We aimed to develop a QPL specific to adults with EoE by incorporating input from national esophageal experts.

Methods: Sixteen gastroenterologists with expertise in EOE were invited to generate QPL content through a modified Delphi (RAND/University of California, Los Angeles) method, consisting of two rounds of independent ratings. In round one, experts provided five answers to the prompt “what general questions should patients ask when being seen for EoE?” and “what questions do I not hear patients asking but given my experience, I believe they should be asking?” In round two, experts rated each question on a five-point Likert scale, and responses were rated as “essential” or “important”, determined by an a priori median threshold of ≥ 4.0 (Figure 1).

Results: Ten esophageal experts agreed and participated in both rounds (Table 1). Round one generated 100 questions. Questions were combined and modified to reduce redundancy, yielding 60 questions. After round two, 51 questions (85%) were accepted for inclusion (median value ≥ 4.0) in the final QPL. Questions were then divided into 4 themes based on disease domains: 1. “What is EoE? 2. “Treatment Options”; 3. “Follow-up Surveillance & Long-term Risks”; and 4. “Allergy and Genetic Testing”. The largest number of questions covered “What is EoE?” (16/51 or 31%). Questions with the highest agreement median (5.0) included examples such as “what should I do if I get a food impaction?” and “what are the treatment options?”.

Discussion: This is the first EoE-specific QPL developed in the field of medicine. We anticipate implementation will increase patient engagement and therefore improved health outcomes. Future studies will aim to modify this communication tool and incorporate patient input prior to usability and feasibility testing.




Disclosures:


Sudharshan Achalu, BA¹, Rani Berry, MD¹, Meera Bhargava, MS¹, Albert J. Bredenoord, MD², Joy W. Chang, MD, MS³, Evan S. Dellon, MD, MPH⁴, Gary Falk, MD, MS, FACG⁵, Nielsen Fernandez-Becker, MD, PhD⁶, Ikuo Hirano, MD⁷, Jennifer L. Horsley-Silva, MD⁸, David Leiman, MD, MSHP⁹, Kristle Lee Lynch, MD¹⁰, Kathryn Peterson, MD, MSCI¹¹, Afrin N. Kamal, MD, MS¹. P0437 - Esophageal Expert Development of a Disease-Specific Question Prompt List for Adults With Eosinophilic Esophagitis: A Modified Delphi Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.