N24 At Home Calprotectin a United Kingdom Patient Perspectives and Tertiary Center Experience
Avery, P.(1)*;Adio, J.(1);Cornford, R.(2);Younge, L.(1);
(1)St Marks Hospital and Academic Institute, Inflammatory Bowel Disease, London, United Kingdom;(2)Northwick Park Hospital, Clinical Biochemistry, London, United Kingdom;
Background
Home faecal calprotectin tests (HFCT) have been available for some years with slow uptake to use in the UK. During the Sars-Cov-2 pandemic use increased as it allowed a measure of disease activity when lab testing in some areas ceased. In a United Kingdom tertiary referral IBD unit, CalproSmart was introduced in 2020. We analysed completion rates of HFCT and the barriers and enablers patients experienced in its use.
Methods
Data from the CalproSmart portal was analysed. Total patients registered was compared against the number that had completed a test. Age, sex and return rates per annum as well as local or out of area patients were included.
All patients who enrolled to receive a HFCT were sent an anonymous online questionnaire using MS Forms. Descriptive statistics were used to analysis the results with a thematic analysis of free form text answers.
Results
A total of N=304 patients were enrolled on the CalproSmart portal over a three-year period from October 2020 until July 2021. HFCT was completed by 118 (39%) of these patients. Completion was highest in 2020 78% of patients who enrolled on the system completed a HFCT. There was a slight trend towards females being more likely to complete at 23% versus 16% of males. There was no sign of age as a determinant to completion. Of the 118 patients who completed the HFCT 84 (71%) were out of local area patients and 34 (29%) local patients.
There were 54 (17%) questionnaires returned. All but 4 (7%) respondents had attempted or completed the HFCT. When asked why they wanted to try a HFCT 39 (72%) patients indicated not having to go to hospital/GP as their primary reason with getting an instant result 29 (54%) and seeing your own result 27 (50%) coming in next. 13 (24%) cited more disease control as a reason to try the test. People found the test mostly easy to use but when comparing overall happiness with the HFCT kits 9 people reported they were somewhat unhappy or unhappy. People were either happy or unhappy with the HFC test usability is a theme that is generated as a barrier and a facilitator for some (see figure 1). When asked which they would prefer to do in future CalproSmart at home or bring your sample to either your GP or hospital n=45 (83%) preferred HFCT.
Figure 1 Q 12 Overall how happy were you with CalproSmart home calprotectin kit? Free text answer comparison
Conclusion
During the pandemic HFCT were popular and out of area patients were more likely to complete the kits. Despite the low return rates those that chose to complete HFCT were in most of cases happy to continue HFCT. With, attention to patient selection and enhanced training on the HFCT there is a case for the continued use in services that have altered significantly since the pandemic.