The Pediatric Inflammatory Bowel Disease Medical Home: A Proposed Model

Hilary K Michel; Brendan Boyle; Jennie David; Amy Donegan; Barb Drobnic; Courtney Kren; Ross M Maltz; Hannah N McKillop; Megan McNicol; Melanie Oates; Jennifer L Dotson

doi:10.1093/ibd/izab238

The Pediatric Inflammatory Bowel Disease Medical Home: A Proposed Model

Inflamm Bowel Dis. 2022 Sep 1;28(9):1420-1429. doi: 10.1093/ibd/izab238.

Authors

Hilary K Michel^{1

2}, Brendan Boyle^{1

2}, Jennie David³, Amy Donegan^{1

2}, Barb Drobnic¹, Courtney Kren¹, Ross M Maltz^{1

2

4}, Hannah N McKillop^{2

3}, Megan McNicol⁵, Melanie Oates¹, Jennifer L Dotson^{1

2

6}

Affiliations

¹ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
² Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH, USA.
³ Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA.
⁴ The Center for Microbial Pathogenesis, The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
⁵ Department of Pharmacy, Nationwide Children's Hospital, Columbus OH, USA.
⁶ The Center for Innovation in Pediatric Practice, The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.

PMID: 34562013
DOI: 10.1093/ibd/izab238

Abstract

Care for patients with inflammatory bowel disease (IBD) can be complex and costly. Care delivery models to address these challenges and improve care quality are essential. The patient-centered medical home (PCMH), which was developed in the primary care setting, has recently been applied successfully to the adult IBD population. Following the tenets of the PCMH, this specialty medical home (SMH) emphasizes team-based care that is accessible, comprehensive, patient/family-centered, coordinated, compassionate, and continuous and has demonstrated improved patient outcomes. Children and young adults with IBD have equally complex care needs, with additional challenges not faced by the adult population such as growth, physical and psychosocial development, and transition of care from pediatric to adult providers. Thus, we advocate that the components of the PCMH are equally-if not more-important in caring for the pediatric patient population. In this article, we review what is known about the application of the PCMH model in adult IBD care, describe care delivery within the Center for Pediatric and Adolescent IBD at Nationwide Children's Hospital as an example of a pediatric IBD medical home, and propose a research agenda to further the development and dissemination of comprehensive care delivery for children and adolescents with IBD.

Keywords: Crohn’s disease; comprehensive care; multidisciplinary; patient centered medical home; ulcerative colitis.

Plain language summary

This article summarizes the literature regarding the adult inflammatory bowel disease medical home, highlights the need for similar models in pediatrics using the Nationwide Children’s Hospital program as an example, and outlines next steps to support research and development of the pediatric IBD medical home.

Publication types

Review

MeSH terms

Adolescent
Child
Chronic Disease
Delivery of Health Care
Humans
Inflammatory Bowel Diseases* / psychology
Inflammatory Bowel Diseases* / therapy
Patient-Centered Care*
Quality of Health Care
Young Adult