TOP 60 - Assessing Pediatric Primary Care Provider Perspectives on Care of Latent Tuberculosis

Publication Number: 1819.TOP 60

Shireen Roy, University of Washington School of Medicine, Seattle, WA, United States; Caitlin McGrath, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Yasaman Fatemi, University of Washington School of Medicine, Seattle, WA, United States

Background: Approximately 13 million people in the United States have latent tuberculosis infection (LTBI). The USPSTF guidelines recommend that primary care teams screen for latent tuberculosis in patients at high risk; however, there is an established gap between those who are at risk and screened for LTBI, between those who are screened and then receive treatment, and between those who initiate treatment and complete it. Pediatric provider comfort with screening for tuberculosis, treating LTBI, and guiding patients in terms of adherence, treatment monitoring, and isolation guidelines is unknown. Infectious disease specialists continue to receive referrals for care of uncomplicated pediatric LTBI. Providers face a number of barriers at individual, practice-based, and systems levels to screening for and treating LTBI, including limited time during appointments, lack of familiarity especially in practices with low prevalence of disease, lack of education around tuberculosis care, and limited resources to monitor adherence and safety during treatment.

Pediatric primary care provider comfort with LTBI care is unknown. Our work will explore attitudes towards tuberculosis (TB) care in this specific setting and serve as a starting point for potential interventions to improve TB care in the greater Seattle area for pediatric patients.

Objective: We aim to assess perspectives of pediatric primary care providers in Washington state with multiple steps in the care cascade for tuberculosis: risk assessment, screening, treatment, follow-up, isolation guidelines, etc. We will assess expectations of pediatric primary care providers of the role of Infectious Diseases physicians in pediatric TB care. Our ultimate goal is to identify potential interventions to address screening and treatment of LTBI by primary care providers in this region.

Design/Methods: We designed a survey that assesses perspectives of primary care providers around pediatric LTBI care using qualitative and quantitative methods. The study was deemed IRB exempt. We piloted the survey with relevant stakeholders. The survey is distributed to providers caring for pediatric patients using professional networks and distribution lists. We will examine whether certain factors such as years in practice, percentage of patients at risk of tuberculosis, etc., are associated with low confidence in tuberculosis care. We will also analyze when providers typically involve Infectious Diseases and analyze the qualitative data for common themes and potential opportunities for future interventions.