Unmet social needs in pediatric patients with inflammatory bowel disease linked to increased risk of missed appointments

Abstract Objectives Health‐related social needs (HRSNs) are associated with worse health outcomes. This study aimed to identify unmet HRSNs in pediatric patients with inflammatory bowel disease (IBD) and evaluate their association with missed medical and biologic infusion appointments. Methods This study was conducted in an ambulatory pediatric gastroenterology program and infusion center from December 2021 to December 2024. Patients with IBD or guardians completed a standardized HRSNs screen. The primary outcome was the number of missed medical and infusion appointments in the year prior to screening. Bivariate and multivariable models without and with adjustment for socio‐demographic characteristics were used. Results A total of 191 patients with IBD were screened (median age 16 years, 68.59% male). Overall, 17.8% screened positive for HRSNs. Among patients with at least one completed medical appointment ( n = 184), 54% had one or more missed appointments. Patients with HRSNs had a 63% (incidence rate ratio [IRR]: 1.63, 95% confidence interval [CI]: 1.11, 2.38, p = 0.0121) higher rate of missed medical appointments, which remained significant after adjusting for race/ethnicity, age, and sex (IRR: 1.56, 95% CI: 1.07, 2.28, p = 0.0212). Inadequate housing (8.38%), followed by food insecurity (6.81%) were the most prevalent HRSNs in our pediatric population. Unmet needs related to utilities ( p = 0.0013), transportation ( p = 0.0014) and healthcare cost ( p = 0.0282) were significantly associated with missed appointments. Positive HRSNs were not associated with missed biologic therapy infusions ( p = 0.155). Conclusion HRSNs were significantly associated with missed medical appointments. Future research should aim to develop strategies that address specific HRSNs, along with personalized interventions to the individual circumstances.