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P518 Compliance with Faecal calprotectin home testing as standard during COVID-19 pandemic compared to laboratory based testing pre-COVID.

Edwards, D.(1);Ibrahim, M.(2);Cooney, R.(2);Boulton, R.(2);

(1)University of Birmingham, Medical school, Birmingham, United Kingdom;(2)University Hospitals Birmingham, Gastroenterology, Birmingham, United Kingdom

Background

Faecal calprotectin (FC) testing has become a standard non-invasive tool to monitor disease control in Inflammatory Bowel Disease (IBD)(1). Reported patient compliance with submitting samples for hospital testing has been as low as 35% (2). We aimed to evaluate patient compliance with rapid home faecal calprotectin testing kits compared to hospital based testing in our university teaching hospital.

Methods

100 patients with a diagnosis of IBD for at least 1 year and attended IBD clinic between January 2019 and August 2020 were selected. Our laboratory ceased performing FC testing in late March and we introduced home testing (BÜHLMANN IBD doc). 50 patients who were, pre-pandemic, requested to bring a stool sample to the laboratory for hospital-based ELISA testing were randomly selected. We compared these to 50 random patients who had a home-based FC testing. Patients who were supplied with home testing kits received training from IBD nurses as well as on-line training materials. Data was collated retrospectively. Compliance was recorded if result was documented within 6 weeks of request.

Results

Prior to the introduction of home testing, only 52% of the patients’ sampled complied with hospital-based testing. This compared to a 70% compliance rate, when home testing was requested (Figure 1).


Figure 1. Comparison of percentage of compliance between hospital and home faecal calprotectin test request.

Conclusion

The improvement in FC testing compliance with rapid home testing kit compared to laboratory based testing illustrates the benefit of adapting home testing as the standard in future. The considerable increase in compliance by home testing may be due less disruption to patient’s personal life i.e., ability to undergo testing at home, symptoms such as faecal incontinence preventing patients delivering samples to hospital and COVID pandemic compelling patients to stay at home. Adopting rapid FC home testing as standard provides patients with increased locus of control regarding their care, providing health care professionals with rapid results, thus, will improve management of IBD. The ability for patients to perform home test has obvious advantages during the COVID pandemic.

References

1. Sands BE. Biomarkers of Inflammation in Inflammatory Bowel Disease. Gastroenterology. 2015 Oct;149(5):1275-1285.e2.

2. Maréchal C, Aimone-Gastin I, Baumann C, Dirrenberger B, Guéant JL, Peyrin-Biroulet L. Compliance with the faecal calprotectin test in patients with inflammatory bowel disease. United European Gastroenterol J. 2017 Aug;5(5):702-707

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