N05 IBDoc® Faecal calprotectin self-test retrospective audit in a District General Hospital (DGH)
P. Avery, K. Blackmore, C. Angel
Dorset County Hospital, inflammatory bowel disease, Dorchester, UK
Background
In 2016, a DGH in England commenced the IBDoc® Faecal calprotectin test. Using smart phone technology, the test can provide results as quickly as 2 hrs. An audit of patients who trialled the test was presented at ECCO in 2017; this abstract looked at the value of the tests and helped to show the investigations worth to the DGH trust. The continued use of the test at the trust has recently been audited and these data are presented by the authors to help further understand the benefit.
Methods
A retrospective audit of patients enrolled on the IBDoc® between July 2017 and October 2019 was carried out by the IBD nursing team. Electronic patient records were searched and corresponding endoscopic assessments that had been carried out within 6 months of the most recent IBDoc® results, were documented for each patient. The terms normal/mild, moderate and severe were used to categorise inflammation seen at colonoscopy, flexible-sigmoidoscopy (C/FS) and/or histopathology (HP). The IBDoc® uses the categories normal (<150) moderate (<400), and high (>400); these values have been set locally easy comparison of these data is possible due to the three levels of stratification. The reason for the endoscopic investigation was also documented. In the sample where no endoscopic investigation was recorded, outcomes were categorised into three groups; well (W), increase monitoring (IM), and treatment adjustment required (TAR).
Results
134 patients are signed up to the IBDoc®, 23 patients failed to carry out the test successfully (CD 14 and UC 9). 6 did not accept a test in clinic due to changing their mind or failure in smart phone technology, 12 did not do the test before expiry* and 5 failed to give a result due to difficulties completing the test. *Myriad of reasons were given for not doing the test and another paper could be written to attempt to understand the persons motivation for not completing the test. Of the 111 patients’ (CD 55, UC 56, IBDU 2 and non-IBD 2), 80 patients did not undergo a C/FS, of the 31 that did, correlation between calprotectin, C/FS and/or HP result was 84%. at 100% best correlation was seen in the severe C/FS results and high IBDoc® results. C/FS were carried out for diagnosis (
Conclusion
The above data shows continuing value of the IBDoc® faecal calprotectin self-test, and there is correlation seen in the comparative results. This data also helps separate well from unwell patients, offering further opportunities to promote supported self-management in people with IBD and prioritisation of clinic appointments.