Coeliac disease audit

Yulia Dewi
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

• Osteoporosis
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
PCSG (2)

• Annual assessment tests

• Disease prevention
• Lifestyle advice
• Vaccinations

• Role of primary care team

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

Audit standard

• Patients diagnosed with coeliac disease

are recommended to have an annual
review, with appropriate blood tests,
either in primary or secondary care.
Method
• SystemOne

• Went back through notes for 2 years -

annual review

• Used hosp letters for confirmation

• Checked pathology results

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
Audit cycle
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
Implementing change (2)
• Guidance on prescribing
• 'Gluten-free foods: a prescribing guide'

• If discharged from hosp care, add to

practice review list
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?
You tube education
• http://www.youtube.com/watch?v=pVIzN
ElnnBc