N807 The use of a pre-screening tool for anti-TNFs in IBD in four North West NHS trusts: a study

Abstract

Background: Inflammatory Bowel disease therapies have continued to evolve following the introduction of anti TNF agents. It is recognised that pre-screening for these therapies varies nationwide, with no standardised requirements evident [1]. The aim of this study is to identify if current pre-screening practice within four independent North West England NHS trusts are in line with the European Crohns and Colitis Organisation (ECCO) consensus [2,3]. Methods: A retrospective multicentre cohort study was conducted examining the aspects of the existing pre-screening tools to determine utilisation in each of the four participating NHS trusts. Results: Ten patients from each NHS trust (N=40)were included, three out of the four trusts had a pre-existing tool for screening. 62% of patients had Crohns disease with the remaining 38% having ulcerative colitis, there were a greater number of males and the age group 18–35 being the most prevelant. 50% of patients were starting Adalimumab, 40% a biosimilar with the remaining 10% Vedolizumab. Assessing the screening outcomes the study identified, EBV Serology, smear testing and results, vaccination history and skin assessment as areas that were not consistantly reviewed (10–28%). Not all trusts had access to faecal calprotectin but Gamma Interferon with Hepatitis and virology screening were done in 98–100% of cases. The majority of the pre-screening was done by the IBD Nurse Specialist (27/40)with the time to treatment showing that 50% of the patients waited over 14 days to commence therapy although 25% of these patients chose to wait over the 14 days [4]. Figure 1. Results. Conclusions: The four participating North West NHS Trusts identified the need for a standardised pre-screening tool for Inflammatory bowel disease patients requiring anti TNF therapy. This is necessary to ensure conformation and uniformity locally and nationally. Following the introduction of a standard pre-screening tool across the four sites a further audit in 6 months is anticipated.