The

UK IBD Audit: Interac:on with the UK IBD Registry. On behalf of UK IBD Audit Steering Group
Professor Chris Probert
Professor of Gastroenterology Ins:tute of Transla:on Medicine, University of Liverpool Wednesday 26th June 2013

Se.ng Quality Standards

UK IBD Audit

UK IBD Audit Components Across Rounds

2006 Organisa:on Clinical Paediatrics Primary care Pa:ent experience Biologics X X 2008 X X X 2010 X X X X X X X X 2012 X X X

 Move to a prospec:ve iden:ca:on Larger number of pa:ents with small data set Inclusion of pa:ent based outcomes
Pa:ent experience Quality of Life

Methodological Development Over Rounds

Answer specic ques:ons more reliably

Re-working of biologics element Future audit focus on outpa:ent care and outcome based data

Key ndings Surgery

Inpa@ent Ac@vity No of admission where surgery undertaken

2006
1/06/05 31/05/06

2008
1/09/07 31/08/08

2010
1/09/09 31/08/2010

(5 - 30) 17 (9 - 40) Median & inter-quar@le range

11

10 (4 - 18) 13 (8 - 25)

8 (3 - 18) P=0.007 12 (6 - 24) P=0.015

Key ndings Pa@ent Focused Care

Standard C2 Rapid access to specialist advice

2008 WriMen info on whom to Yes = 69% contact when relapse? (120/174) Expect to be seen within 7 days of a relapse? Can contact an IBD Specialist by: Phone Drop in clinic E-mail Yes = 69% (120/174) 85.7% (150/175) 11.4% (20/175) 40% (70/175)

2010 Yes = 80.5% (140/174) Yes = 88.5% (154/174 94.3% (150/175) 9.8% (20/175) 56.3% (70/175) p<0.014 p<0.001

P=0.008 P=0.615 P=0.002

Key ndings Adult IBD Care - UC

2006 Mortality Previous admissions Seen by an IBD Nurse during admission? Were stool samples sent? 34/1953 (1.7%) 829/1621 (51.1%) 395/1667 (23.7%) SSC 738/1120 (65.9%) CDT 604/1120 (53.9%) 905/1668 (54.3%) 2008 31/2016 (1.5%) 750/1655 (45.3%) 496/1653 (30.0%) SSC 857/1160 (73.9%) CDT 770/1160 (66.4%) 1220/1649 (74%) 2010 16/1948 (0.8%) * 421/1255 (33.6%) * 725/1614 (44.9%) * SSC 961/1189 (80.8%) * CDT 882/1173 (75.2%) * 1406/1614 (87.1%) *

Prophylac:c Heparin

Pa@ent Experience

Biologics Audit First Ac@vity for Registry?

Steady increase in activity. Learning process Interaction between users and centre pivotal to ongoing use.

IBD Audit & QI

IBD Standards

IBD Registry

IBD Research

Where next? pa@ent care

Registry to underpin: Local audit vs na:onal audit Benchmarking ac:vity Discussion with CCGs

Where next? - research

Epidemiology Treatment palerns and outcome (Biologics withdrawal) Work with Pharma

Acknowledgements
CEEu
Aimee Protheroe Kevin Stewart Susan Murray Hannah Barnes Derek Lowe Rhona Buckingham Jane Ingram

CCUK
David Barker Richard Driscoll Elaine Steven

BSG
Jon Rhodes John Williams

Contact: Ibd.audit@rcplondon.ac.uk 020 3075 1566/1565 www.rcplondon.ac.uk