AN ASSESSMENT OF HEALTHCARE PROFESSIONAL KNOWLEDGE REGARDING INVESTIGATIONAL STEM CELL THERAPIES FOR PATIENTS WITH CROHN'S PERIANAL FISTULA: A US MULTISPECIALITY EDUCATIONAL NEEDS SURVEY. (26th January 2023)

• Record Type: Journal Article
• Authors: Salinas, Greg; Belcher, Emily; Cazzetta, Susan; Nazarey, Pradeep; Stacy, Sylvie
• Is Part Of: Inflammatory bowel diseases. Volume 29(2023)Supplement 1
• Page Start: S63
• Page End: S63
• Publication Date: 2023-01-26
• Subjects: Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izac247.120
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: BACKGROUND: Crohn's perianal fistulas (CPFs) are a common complication in patients with Crohn's disease. Stem cell therapies are under investigation for the treatment of CPF; however, understanding amongst healthcare professionals (HCPs) is unknown and their educational needs have not been assessed. This study aimed to assess HCP familiarity with stem cells, their potential application in treating CPF and factors that may influence their use. METHODS: An online educational needs survey was developed and distributed to HCPs, including gastroenterology and colorectal surgery specialists and primary care physicians (PCPs). Questions focused on the types of stem cells showing promise in treating CPF, their proposed mechanism(s) of action and familiarity with stem cell therapies. Factors influencing HCP treatment decisions regarding stem cell use in patients with CPF were also assessed. Results were reported using descriptive statistics. RESULTS: Overall, 433 HCPs completed the survey, including: 151 PCPs; 127 gastroenterologists (GEs); 78 colorectal surgeons (CRSs); 63 GE nurse practitioners/physician assistants (NPs/PAs); and 14 CRS NPs/PAs. Uncertainty regarding the mechanism(s) of stem cell action for perianal fistula (PF) healing was reported in more than half of the surveyed PCPs and GE NPs/PAs (52% and 54%, respectively) and under half of the surveyed GEs, CRSs and CRS NPs/PAs (39%, 35% and 43%, respectively). Excluding GEs (42%), most HCPs (PCPs: 67%; CRS NP/NPAs: 64%; GE NP/NPAs: 60%; CRSs: 55%) were unsure about which stem cell types had shown promise in treating CPF. Regarding stem cell use in CPF, gastroenterology and colorectal surgery specialists considered clinical trial outcomes, particularly the success rate of PF healing and the safety profile of stem cells reported in clinical trials, as the most significant factors influencing decisions to use an approved stem cell therapy, with mean (standard deviation; SD) scores on a five-point scale of 4.2 (0.8) and 4.3 (0.7) for the success rate of PF healing and 4.1 (0.8) and 4.2 (0.8) for the safety profile, respectively. For PCPs, the success rate of PF healing reported in clinical trials and cost/insurance coverage were considered the most significant factors, with mean (SD) scores of 4.1 (0.8) and 4.0 (1.0), respectively. CONCLUSIONS: HCPs would benefit from more information and education on stem cell therapies for CPF, notably on the types of stems cells and mechanism(s) that lead to PF healing. Effective communication of stem cell clinical efficacy and safety data, alongside information on the cost/insurance coverage of stem cell therapy are all required to inform recommendations on the use of stem cells for treating patients with CPF.