View 2019 Abstracts

TitleProposing audit standards for the multidisciplinary management of Graves’ Orbitopathy (GO).
Submitted bySoma Farag
Abstract Number338
Review Resultposter presentation
Purpose

Currently there are no established national audit standards for the management of Graves’ orbitopathy (GO) in the UK. Early diagnosis and treatment of GO is essential to prevent sight-threatening complications and long-term disability and therefore establishing a standard of care is highly desirable. Eight audit standards were proposed, deriving from existing guidelines by EUGOGO and TEAMeD 5.

Methods

A retrospective analysis of 136 patients referred to 2 GO multidisciplinary (MDT) clinics between 2016-2019. Audit standards were determined as follows; i) time between referral and specialist review ii) offering of smoking cessation and selenium supplementation where appropriate iii) time to initiation of intravenous methylprednisolone (IVMP) in selected patients iv) time to orbital radiotherapy and orbital decompression following a clinical decision.

Results

Mean patient age was 49.2 yrs, 73.1% female, 52.9% white caucasian. Mean initial clinical activity score (CAS) was 2.4 (range 0-7). Of the 136 patients, 51 received IVMP for active moderate-severe GO and the mean time to treatment was 5.2 days. All patients with sight-threatening GO were seen and treated within 2 weeks. There were 23/136 (16.9%) current smokers, all of whom received documented smoking cessation advice. Selenium supplementation was recommended to 75.4% of the patient cohort.

Conclusion

The increasing recognition that an MDT approach is optimal for the management of GO requires a strong clinical governance framework. Here we have proposed a set of clinically relevant quality standards derived from two high volume GO MDT clinics. These standards inform the debate defining high quality care and resource allocation for GO in the UK.


Additional Authors

Last nameInitialsCity / HospitalDepartment
FeeneyCWestern Eye HospitalEndocrine
LeeVWestern Eye HospitalEye
MeeranKCharing Cross HospitalEndocrine
RobinsonSSt Mary’s HospitalEndocrine
BravisVSt Mary’s HospitalEndocrine
JainRWestern Eye HospitalOphthalmology
AzizAWestern Eye HospitalOphthalmology