Referral patterns for the interdisciplinary care of chronic pelvic pain

Abstract

Objective:

The primary objective of this study was to describe referral patterns to an interdisciplinary CPP clinic at a tertiary care center.

Study design:

This was a retrospective cohort study of female patients assigned an ICD-10 code diagnosis related to chronic pelvic pain at a tertiary care referral center between January 2017 and December 2019. Electronic medical records were queried for patient and clinician characteristics. The rate of referral to this clinic was determined based on the data collected, and patient and provider factors associated with referral were assessed using logistic regression analyses.

Results:

Of the 732 patients identified, 25.9% (n = 190, 95% CI = [22.9%,29.3%]) received a referral to an interdisciplinary CPP clinic. Logistic regression analyses significantly revealed multiple factors associated with referral: number of previous treatment modalities used (adjusted OR [aOR] = 1.76 per treatment 95% CI = [1.48, 2.10], p < 0.001), distance to the treatment center (aOR = 0.48 [0–25 miles vs 25–60 miles] 95% CI = [0.31, 0.74], p < 0.001), IBS diagnosis (aOR = 1.67 95% CI = [1.02, 2.74], p = 0.044), endometriosis diagnosis (aOR = 1.63 95% CI = [1.06, 2.52], p = 0.026), as well as a psychiatric diagnosis (aOR = 1.46 95% CI = [1.00, 2.12], p = 0.048). Physicians were less likely to make a referral compared to Advanced Practice Providers (aOR = 0.38 95% CI = [0.22, 0.65], p < 0.001).

Conclusion:

Approximately one in four patients with a diagnosis of CPP were referred to our interdisciplinary clinic. Several patient factors were associated with referral. These data show a need for education about the existence of this type of center.