299 - Perspectives of Internal Medicine Primary Care Providers on Caring for Young Adults with Neurodevelopmental Disabilities

Anonymous Qualtrics web-based survey consisting of 8 multi-step questions about primary care confidence caring for patients with NDD was sent to IM primary care providers.  Twenty-eight random resident and attending primary care physicians in the IM Department at Boston Medical Center, an urban academic safety-net hospital answered the survey.

Results: The survey included 28 (IM) providers with 50% with less than 5 years in practice and 50% with more than 5 years in practice.  Half of respondents reported not feeling confident or unsure working with young adult patients with NDD  (Figure 1). Confidence levels in the ability to treat behavioral issues associated with NDD were lowest at 35% out of a series of NDD conditions (Figure 2). Notably, 75% of respondents felt their lack of confidence was attributed to lack of training and experience; 60% due to lack of navigation or care coordination support; 53% due to lack of appointment time to address patient needs (Table 1). The top three desired supports for future initiatives included: list of adult specialists experienced in caring for patients with NDD, communication with previous pediatric providers during the transition period and navigator or care coordinator support.

Conclusion(s): Our findings highlight reduced confidence in IM providers to off primary care for patients with NDD. IM providers lack the experience, training, and support to feel confident caring for this vulnerable patient population. Potential initiatives to improve this care gap includes better education, communication and navigational support.