Coeliac disease audit Liz Bartlett ST2 Brig Royd, Ripponden

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Coeliac disease audit

• Liz Bartlett ST2
• Brig Royd, Ripponden

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Coeliac disease
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Guidelines

• NICE
• British Society of Gastroenterology
• Primary Care Society for Gastroenterology

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British Society of Gastroenterology (BSG)

• Annual review with blood tests
• Assess symptoms
• Consider referral
• Osteoporosis

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Primary Care Society for Gastroenterology (PCSG)

• Annual review
• Database and named lead
• Audited annually to ensure following recorded
• Compliance with gluten free diet
• Nutritional status
• BMI
• Osteoporosis assessment

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PCSG (2)

• Annual assessment tests
• Disease prevention
• Lifestyle advice
• Vaccinations
• Role of primary care team

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Why is an annual review necessary?

• Coeliac disease linked to other conditions
• Decreases complications
• Preventive medicine
• Supports patient, aids adherance to diet
• No QOF points for annual review

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Audit standard

• Patients diagnosed with coeliac disease are
  recommended to have an annual review, with
  appropriate blood tests, either in primary or
  secondary care.

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Method

• SystemOne
• Went back through notes for 2 years -annual
  review
• Used hosp letters for confirmation
• Checked pathology results

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Results

• 52 (16pts) had secondary care FU
• - 81 (13pts) of these attended appt
• 42 (13 pts) had no FU
• 3 (1 pt) arranged own FU with GP
• N/A for 1 pt, diagnosed within a year
• All pts followed up in secondary care had blood
  tests

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Audit cycle
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Implementing change

• Database of patients
• Letter inviting in for review
• Nurses to undertake annual review
• Compliance, BMI, symptoms
• Lifestyle advice
• Review prescription foods
• Support
• Coeliac UK (templates)?
• Referral to GP if needed

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Implementing change (2)?

• Guidance on prescribing
• 'Gluten-free foods a prescribing guide'
• If discharged from hosp care, add to practice
  review list

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Future considerations

• Re-audit using database
• Are patients having DEXA scans according to BSG
  guidelines? If not should they be offered in
  primary care?
• Are patients being offered pneumococcal and
  annual influenza vaccine?
• Use of PHQ-9?

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You tube education

• http//www.youtube.com/watch?vpVIzNElnnBc