{
  "abstract": "Introduction Whilst uncomplicated idiopathic pericarditis rarely leads to life-threatening complications, it can impose a significant burden on both the patient and the healthcare system, particularly if it progresses to persistent or recurrent pericarditis. The symptoms can be disabling and result in recurrent presentations, and sometimes unnecessary investigations. We used the ‘2015 ESC Guidelines for the diagnosis and management of pericardial disease’ as gold standard for pericarditis care and looked at local adherence to these recommendations. Finding this to be poor, we developed and promoted a pathway, then re-audited adherence shortly after the pathway was introduced.Methods Patients were identified by searching for diagnostic codes relating to pericarditis on our electronic patient record in a district general hospital. The first audit cycle included June 2021 to May 2022, the second March to August 2024. Data was then extracted manually from the patient records.Results The two audit cycles had similar numbers of patients (47 then 45) with comparable ages (mean 39 then 38 years), but a higher male predominance in the second cycle (86% up from 68%). Similar proportions were managed primarily by cardiology (47% then 51%), GIM (21% then 16%) and ED (32% then 33%).In the second cycle, 33% of patients received appropriate doses of non-steroidal anti-inflammatory drugs (NSAIDs), up from 23% in the first cycle. 80% of patients given NSAIDs were recommended a proton pump inhibitor, up from 56% in the first cycle. Overall, the percentage of patients receiving pericarditis-dose NSAIDs with gastric protection rose from 11% to 25%. There was also an increase in the use of colchicine from 28% to 58%.The ESC guidelines recommend (grade 1B recommendation) a review after 1 week from presentation. Our first cycle revealed that only 45% of patients had follow up arranged, with much of this likely to be delayed (for example, one appointment was booked for four months later), or relying on overburdened primary care services. In our second cycle, 68% of patients had follow up arranged; 70% of the follow up was with the cardiology hot clinic which typically sees patients within 1–2 weeks.Conclusion A clear pathway including guidance on prescribing, and with availability of timely review, can improve adherence to guidelines for the management of uncomplicated pericarditis. This could improve both patient outcomes and the responsible use of local resources. Clearly, there is more work to be done with promoting awareness and adherence to the pathway, which will continue to be audited.",
  "authors": [
    {
      "affiliations": [
        "SpR, East and North Hertfordshire NHS Trust (ENH)"
      ],
      "name": "Anna Goodhart"
    },
    {
      "affiliations": [
        ", Consultant Cardiologist, ENH"
      ],
      "name": "Mosaad Elbanna"
    },
    {
      "affiliations": [
        "FY1, ENH"
      ],
      "name": "Aleksandra Kamizela"
    }
  ],
  "title": "1-019 Using a hot clinic pathway to improve pericarditis care",
  "uid": "588a2b0e-ef63-5909-bec8-ec0f1f813314"
}