P336 Evaluating compliance with NICE guidance in the management of patients with chronic pancreatitis

Introduction

The National Institute for Health and Care Excellence (NICE) set standards for the management of chronic pancreatitis. This study aims to review the compliance with these guidelines of patients assigned to a dedicated pancreatitis clinic in a district general hospital.

Methods

A retrospective analysis of patients reviewed in the pancreatitis clinic between January 2022 and December 2022 was completed. Data was collected from patients with a diagnosis of chronic pancreatitis. Management was evaluated against NICE guidance.

Results

A total of 50 patients were identified for this study. of these, 41 patients (82%) had a radiological diagnosis of chronic pancreatitis. 36 patients (72%) demonstrated pancreatic exocrine insufficiency (PEI) with low faecal elastase. 100% of these 36 patients were established on pancreatic enzyme replacement therapy. In accordance with NICE guidance, 48 patients (96%) had endocrine function assessed by means of HbA1c, with 84% meeting the NICE recommendation of 6 monthly testing. 45 patients (90%) had haematinics checked in line with nutritional assessment, with 88% having been tested within the last 12 months as per guidance. 39 of 50 patients (78%) had a PEI screen with faecal elastase in accordance with NICE standards within the last 12–18 months. 9 of the 11 remaining patients (18%) did not return the requested sample. 29 patients (58%) had DEXA scans for bone density assessment as recommended by NICE. 100% of patients had radiological imaging to assess the pancreas. of these, 9 patients (18%) did not have a radiological diagnosis of chronic pancreatitis, though they demonstrated evidence of PEI.

Conclusions

A dedicated pancreatitis clinic was set up in a District General Hospital further to failure in meeting of NICE standards. This study demonstrates significant improvement in compliance with NICE guidance in all 4 areas assessed. We have demonstrated improved patient care in a group of patients poorly managed previously, by providing patient focused care with a specialist multi-disciplinary service.