{
  "abstract": "Faecal calprotectin (FC) is an established biomarker used for monitoring bowel inflammation in paediatric inflammatory bowel diseases (PIBD). ESPGHAN IBD guidelines recommend measurement of FC 6-monthly. 1–3 Additionally, normalisation of FC is a treatment target per STRIDE II.4 Aim report frequency of FC sample measurement in PIBD outpatient setting and whether frequency of FC processing in patients diagnosed with IBD ≥1 year meets the 6-monthly target.Method Retrospective chart review of PIBD patients attending our tertiary centre over six months between 1/1/23–30/6/23. Demographics, diagnosis, duration of diagnosis, FC measurement at clinic visit, interval between FC measurements were recorded. We reported on individual clinic visits and patients diagnosed ≥1 year.Results Total 385 clinic contacts. 218 included for analysis, representing 176 unique patients. 54.5%(n=96) male. 48.8%(n=86) CD. 45.5%(n=80) UC. 5.7%(n=10) IBDU. Median [IQR] age 14 years [11 to 15], duration of diagnosis: 2 years [0.9 to 4.2].Results in table 1:Abstract OC80 Table 1Results Outcome Result%(n) All patients (n=176) FC processed for clinic contact 39.7(87) Patients with diagnosis ≥1 year (n=134) ≥2 FC processed≥2 FC processed, interval ≤6 monthsMedian interval between samples:8 months [4.7 to12.3] 64.9(87)26.1(35) 1 FC processed 28.4(38) 0 FC processed 6.7(9) Patients with ≥ 2 FC Patients with 1 FC Patients with no FC n(male) 114(62) 50(27) 13(8) Age Years, Median [IQR] 13[10 to 15] 14[13 to 15] 13[12 to 16] Diagnosis CD: 50.8UC: 41.2%IBDU: 7.9% CD: 44%UC: 54%IBDU: 2% CD: 53.9%UC: 46.1% Duration of diagnosis Years, Median [IQR] 1.9[0.8 to 4] 2.1 [1 to 4.1] 1.7[0.9 to 5.7] Inter-sample interval Months, Median [IQR] 7.1[4 to 11.1] N/A N/A Only 39.7% of PIBD clinic visits have an associated FC result and we only meet the standard of measuring FC 6-monthly in 26.1% of patients with established diagnoses of IBD ≥1 year. Our processing rate is lower than the currently published data for FC compliance in both children and adults ranging from 66.7–78%.5 6 While our study utilises a large number of patients and a representative spread of diagnoses, a limitation is that we did not investigate reasons for low rates of FC measurement. We suggest the following likely reasons: patients unable to open bowels in clinic on-demand; difficulty obtaining samples from patients living geographically distant to our site; difficulty obtaining results from samples processed in primary care.We introduced the following interventions:Modification of clinic invitation to include reminders to bring stool samples to clinic.SMS reminders the day before clinic to encourage patients to bring stool samples.Patient-lead postal stool samples. This does have financial implications for the patient and trust, in the form of postage and packaging costs to ensure biological substance transport compliance.We suggest these simple technological solutions such as direct messaging patients, and offer postal stool sampling as a safe, effective failsafe. Re-audit post-implementation of interventions is due in 2025.References Koninckx CR, Donat E, Benninga MA, Broekaert IJ, Gottrand F, Kolho K, et al. The use of fecal calprotectin testing in paediatric disorders. J Pediatr Gastroenterol Nutr. 2021 Apr 14;72(4):617–40.van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL, et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. J Crohns Colitis. 2021 Feb 1;15(2):171–94.Turner D, Ruemmele FM, Orlanski-Meyer E, Griffiths AM, de Carpi JM, Bronsky J, et al. Management of paediatric ulcerative colitis, part 1. J Pediatr Gastroenterol Nutr. 2018 Aug;67(2):257–91.Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, et al. STRIDE-II: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology 2021 Apr 1;160(5):1570–83.Queliza K, Wang MK, Kellermayer R. Compliance with fecal calprotectin testing in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2018 Jun;66(6):932–3.Fenton D, Choi NK, Garcia NM, Dyer EC, Cohen NA, Rubin DT. Factors associated with fecal calprotectin sample collection compliance: an IBD center quality improvement project. Crohns Colitis 360 2022 Oct 1;4(4).",
  "authors": [
    {
      "affiliations": [
        "King’s College Hospital NHS Foundation Trust",
        "Chelsea and Westminster Hospital NHS Foundation Trust"
      ],
      "name": "Joseph Machta"
    },
    {
      "affiliations": [
        "Chelsea and Westminster Hospital NHS Foundation Trust"
      ],
      "name": "Dhamyanthi Thangarajah"
    },
    {
      "affiliations": [
        "Chelsea and Westminster Hospital NHS Foundation Trust"
      ],
      "name": "Jenny Epstein"
    },
    {
      "affiliations": [
        "Chelsea and Westminster Hospital NHS Foundation Trust"
      ],
      "name": "Krishna Soondrum"
    },
    {
      "affiliations": [
        "Chelsea and Westminster Hospital NHS Foundation Trust"
      ],
      "name": "JME Fell"
    }
  ],
  "title": "OC80 Clinical audit and quality improvement: faecal calprotectin measurement in paediatric IBD outpatient clinics",
  "uid": "e9422565-314b-5cf4-ab8c-c2d44bee5ef2"
}