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Coeliac disease audit

Coeliac disease audit. Liz Bartlett ST2 Brig Royd, Ripponden. Coeliac disease. Guidelines. NICE British Society of Gastroenterology Primary Care Society for Gastroenterology. British Society of Gastroenterology (BSG). Annual review with blood tests Assess symptoms Consider referral

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Coeliac disease audit

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  1. Coeliac disease audit Liz Bartlett ST2 Brig Royd, Ripponden

  2. Coeliac disease

  3. Guidelines • NICE • British Society of Gastroenterology • Primary Care Society for Gastroenterology

  4. British Society of Gastroenterology (BSG) • Annual review with blood tests • Assess symptoms • Consider referral • Osteoporosis

  5. 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

  6. PCSG (2) • Annual assessment tests • Disease prevention • Lifestyle advice • Vaccinations • Role of primary care team

  7. 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

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

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

  10. 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

  11. Audit cycle

  12. 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

  13. Implementing change (2)‏ • Guidance on prescribing • 'Gluten-free foods: a prescribing guide' • If discharged from hosp care, add to practice review list

  14. 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?

  15. You tube education • http://www.youtube.com/watch?v=pVIzNElnnBc

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