BNP Results from the first 6 months

1
BNP Results from the first 6 months

• Action limits and results reported
• Uptake of BNP by GPs against predicted levels
• Changes in patient management associated with BNP
• GP Questionnaire
• A simple questionnaire was sent out with each
  NT-proBNP report. This asked for basic clinical
  data, medication, and management with and without
  the NT-proBNP result.
• The return rate was 84.

2
ACTION LIMITS and reporting NT-proBNP results

• We report an age and sex-related ref.range (Roche
  data) but use one action limit of 36 pmol/L1. We
  advise that values below this, in untreated
  patients, make heart failure very unlikely
  higher values require further investigation.
• Serum creatinine is also measured, and provisos
  added when creatinine gt200 umol/L.

Results to date up to 36
gt36 pmol/L FEMALES 42 - of whom 55
45 (38-4130) MALES 58 - of whom 50
50 (38-4139)
3
The uptake of BNP by GPs
Predicted funded service
Predicted funded service
Demand from primary care is matching predicted
demand Almost all practices are now using the NT
pro-BNP service some are using it at higher
than funded level
4
Changes in patient management associated with BNP
reduction
60
44
76
38
5
Impact on Echo waits?

• The increase in referrals to echocardiography and
  waits as a result of the new GMS contract has
  been reversed with the introduction of BNP in
  October 2004 enabling the longest wait for echo
  to reduce from 15 weeks in September 2004 to 8
  weeks in March 2005.

6
All Echo Referrals (Out Patient GP Direct
Access non-HF)
7
GP Direct Access Echo Referrals
8
Echo Waits

• Oct 2001 16 weeks
• July 2002 7 weeks (CHD collaborative capacity
  demand management)
• Mar 2004 27 weeks
• Sept 2004 - 15 weeks
• Mar 2005 - 8 weeks
• Longest wait

9
Conclusion

• NT-Pro BNP blood test has
• Provided quicker access for GPs and patients to
  diagnosis of heart failure
• Led to improved patient management by GPs and
  more appropriate referrals for echo, cardiology
  and medical outpatients
• Supported reduction in wait for echo reversing
  increasing referral
• Supported achievement of GMS targets for HF
• Provided cost efficiencies against investment
  made
• Provided patients with improved diagnosis and
  management of heart failure