Id 1080 The Management Of Adult Coeliac Disease In Farranfore Medical Centre, Co. Kerry

Russell A, Shanahan E, Shanahan M
Aim(s) or purpose: Coeliac disease is an autoimmune condition, which is triggered, in genetically predisposed individuals by the consumption of gluten. The prevalence of coeliac disease is 0.5 – 1 %. It has the potential to lead to complications such as reduced bone mineral density, malignancy and splenic atrophy. With strict adherence to a gluten free diet these complications can be avoided. The aim of this study was to audit the management in our practice.
Design and method: 44 patients from the Farranfore Medical Centre, identified on the HEALTH One database, were invited to attend for review. A standardised template was created based on the UK Primary Care Society for Gastroenterology Guidelines on the Management of Coeliac Disease and Northern Ireland CREST Guidelines for the Diagnosis and Management of Coeliac Disease in adults.
Results: Prior to the audit none of the patients had an annual review. 50 % had their bloods checked but not all parameters had been checked. Patients had not been assessed for the complications of coeliac disease such as bone mineral loss and splenic atrophy. At the time of the re-audit cycle 20/44 patients had a full review. Few patients reported any symptoms and there was no correlation between GI symptoms and presence of anti endomysial antibodies on blood testing. Patients were assessed for the complications of coeliac disease. 3/20 patients had Howell Jolly bodies present on blood film indicating splenic atrophy. Patients were referred for DEXA scan to assess bone health. At the time of re-audit 4 patients had completed DEXA scans, which showed varying degrees of bone density loss.
Conclusions: Patients with coeliac disease should have annual chronic disease management follow up. There is now a system in place for annual follow up of these patients which could easily be put into practice in other general practice settings.
ID 1080
The management of adult coeliac disease in Farranfore Medical Centre, CO. Kerry