634 Analgesia Use in Acute Renal Colic Patients- Complete Audit Cycle

Abstract

Abstract Aim Prevalence of renal colic is up to 20% worldwide, with recurrence rates approaching 50% within 10 years- making it a common acute presentation. NICE guidance (NG118) states NSAIDs are first-line analgesia for renal colic, followed by intravenous paracetamol and opiates. Our aim was to assess compliance with NG118 within one acute NHS teaching Trust. Method All patients with renal colic as the primary differential diagnosis during March and April 2022 (1st cycle) and September and October 2022 (2nd cycle) were included. Data was extracted retrospectively from electronic patient records into a pre-designed proforma. Findings from the 1st cycle were presented within local departmental meetings. Posters were also installed reminding clinicians of the analgesic pathway within the relevant clinical areas. Subsequently, a re-audit was performed. Results 90 patients were included (60- 1st cycle, 30- 2nd cycle). There was a significant improvement in compliance between the 1st and 2nd audit cycles (60% versus 83%, p = 0.0193). However in cases of non-compliance, documentation was poor (>70% did not state a reason) during both cycles. Imaging confirmed renal colic in 82% of patients in the 1st cycle and 93% of patients in the 2nd cycle. PR Diclofenac was the most common NSAID prescribed. Conclusions Low-cost, easily reproducible interventions resulted in significant prescribing practice changes. Findings from the latest national renal colic audit (2012-13) showed analgesia compliance in only 69% of cases nationally- similar to our 1st audit cycle results. Disseminating our findings to other hospitals regionally and nationally will hopefully result in better outcomes for renal colic patients.