Evidence in Practice: What a New Prescribing Survey Reveals About EPI Care Gaps

This episode spotlights a recent publication by Ashkar and colleagues—co-authored by Jennifer Geremia—surveying prescribing practices for EPI across a broad cross-section of healthcare professionals. The study included providers from primary care, gastroenterology, pulmonology, and surgery, capturing both APP and physician perspectives.

Key findings revealed that insurance coverage and patient access to therapy were among the top three drivers of product selection—confirming what the panel has observed in clinical practice. Patient assistance programs and provider perceptions of patient-reported outcomes were also influential in prescribing decisions.

Notably, the survey showed meaningful variability in which patient populations providers screen for EPI. Approximately one-third of respondents identified alcohol use as a high-risk category to evaluate, which the panel found informative. Type 2 diabetes ranked higher than expected as a condition prompting EPI consideration, suggesting growing awareness—though still reactive rather than proactive—in that population.

Dr. Kaul reflects that the paper confirms the real-world diversity of approaches to EPI screening and prescribing, reinforcing that the gaps discussed throughout this series are not theoretical—they are documented and persistent. He encourages all viewers to read the paper as a benchmark of current practice. The survey validates the importance of education, standardization, and reducing barriers to access as the core priorities for improvement.

In the final episode, "Closing the Loop: Key Recommendations and Future Directions for EPI," the panel presents their top problem-solving recommendations for clinicians, drawing on everything covered in the series to outline a forward-looking roadmap for improving EPI care.