P368 Service Evaluation of an IBD help line

Abstract

Introduction Dedicated specialist advice lines for patients with IBD (Inflammatory bowel disease) are recommended by the BSG [Lamb CA, et al. Gut 2019;0:1–106] to help prioritise rapid access to advice and specialist clinical input. This project evaluated the efficacy of the service in a tertiary London hospital, particularly its role in managing patients concerns and avoiding hospital admission. Methods A retrospective audit of 1000 IBD patient calls between August 2019 and October 2019 was conducted. The help line covered patients across all Imperial Trust sites – Charing Cross, St Mary’s and Hammersmith Hospitals. The data collected included the following - Time of call, diagnosis, mode of contact, when the call was answered, number of attempts, advice given by whom, call reason and outcome. Results The divide between UC and Crohn’s was approximately equal (46.3% vs 48.5%). Out of the 1000 the majority (809) were direct patient contact. Voicemail was the most common mode of contact (577) followed closely by email (435). 84% of patients were answered on the same day, 12% the next day and 4% on another day. 84% of patients got through on the first attempt while 11% needed a second attempt and 5% required three attempts. Majority of the advice was given via telephone (70%), the second most common was email (24%). Most calls (25%) were regarding investigation/treatment, 21% regarding flares, 12% results, 11% admin, 11% advice, 7% homecare, 4% earlier appointment and 4% side effects. Regarding outcomes – 28% involved investigation/treatment, 13% repeat prescriptions, 13% results, 12% advice, 7% appointments, 5% admin, 3% dose escalation, 3% home care, 3% contacted the consultant, 2% biologics switch, 2% A&E/urgent care referrals and 1% support. Conclusions The service was highly efficient; 85% of calls were answered The majority of calls and outcomes related to investigation, treatment and disease flare-up – demonstrating that the service is being used appropriately. Only 2% of patients required A&E/urgent care referrals, demonstrating that access to specialist advice can reduce or avoid costly hospital admissions. These data are in keeping with systematic reviews that have all shown advice lines to be safe and cost-effective. Medication advice and monitoring was a common use of the advice line – this remote service helps provide a robust platform for toxicity surveillance. In order to maintain the high quality of the service, ongoing IBD Nurse education and prescribing, can help maintain high levels of efficiency, good patient care and a high level of patient satisfaction.