Coeliac Disease

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Coeliac Disease

  1. 1. Coeliac disease audit Liz Bartlett ST2 Brig Royd, Ripponden
  2. 2. Coeliac disease
  3. 3. Guidelines <ul><li>NICE </li></ul><ul><li>British Society of Gastroenterology </li></ul><ul><li>Primary Care Society for Gastroenterology </li></ul>
  4. 4. British Society of Gastroenterology (BSG) <ul><li>Annual review with blood tests </li></ul><ul><li>Assess symptoms </li></ul><ul><li>Consider referral </li></ul><ul><li>Osteoporosis </li></ul>
  5. 5. Primary Care Society for Gastroenterology (PCSG) <ul><li>Annual review </li></ul><ul><li>Database and named lead </li></ul><ul><li>Audited annually to ensure following recorded: </li></ul><ul><ul><li>Compliance with gluten free diet </li></ul></ul><ul><ul><li>Nutritional status </li></ul></ul><ul><ul><li>BMI </li></ul></ul><ul><ul><li>Osteoporosis assessment </li></ul></ul>
  6. 6. PCSG (2) <ul><li>Annual assessment tests </li></ul><ul><li>Disease prevention </li></ul><ul><li>Lifestyle advice </li></ul><ul><li>Vaccinations </li></ul><ul><li>Role of primary care team </li></ul>
  7. 7. Why is an annual review necessary? <ul><li>Coeliac disease linked to other conditions </li></ul><ul><li>Decreases complications </li></ul><ul><li>Preventive medicine </li></ul><ul><li>Supports patient, aids adherance to diet </li></ul><ul><li>No QOF points for annual review </li></ul>
  8. 8. Audit standard <ul><li>Patients diagnosed with coeliac disease are recommended to have an annual review, with appropriate blood tests, either in primary or secondary care. </li></ul>
  9. 9. Method <ul><li>SystemOne </li></ul><ul><li>Went back through notes for 2 years -annual review </li></ul><ul><li>Used hosp letters for confirmation </li></ul><ul><li>Checked pathology results </li></ul>
  10. 10. Results <ul><li>52% (16pts) had secondary care FU </li></ul><ul><li>- 81% (13pts) of these attended appt </li></ul><ul><li>42% (13 pts) had no FU </li></ul><ul><li>3% (1 pt) arranged own FU with GP </li></ul><ul><li>N/A for 1 pt, diagnosed within a year </li></ul><ul><li>All pts followed up in secondary care had blood tests </li></ul>
  11. 12. Audit cycle
  12. 13. Implementing change <ul><li>Database of patients </li></ul><ul><li>Letter inviting in for review </li></ul><ul><li>Nurses to undertake annual review: </li></ul><ul><ul><li>Compliance, BMI, symptoms </li></ul></ul><ul><ul><li>Lifestyle advice </li></ul></ul><ul><ul><li>Review prescription foods </li></ul></ul><ul><ul><li>Support </li></ul></ul><ul><ul><li>Coeliac UK (templates)‏ </li></ul></ul><ul><ul><li>Referral to GP if needed </li></ul></ul>
  13. 14. Implementing change (2)‏ <ul><li>Guidance on prescribing </li></ul><ul><li>'Gluten-free foods: a prescribing guide' </li></ul><ul><li>If discharged from hosp care, add to practice review list </li></ul>
  14. 15. Future considerations <ul><li>Re-audit using database </li></ul><ul><li>Are patients having DEXA scans according to BSG guidelines? If not should they be offered in primary care? </li></ul><ul><li>Are patients being offered pneumococcal and annual influenza vaccine? </li></ul><ul><li>Use of PHQ-9? </li></ul>
  15. 16. You tube education <ul><li>http://www.youtube.com/watch?v=pVIzNElnnBc </li></ul>

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