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Faecal calprotectin testing in UK general practice : a retrospective cohort study using The Health Improvement Network database

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Freeman, Karoline, Ryan, Ronan, Parsons, Nicholas R., Taylor-Phillips, Sian, Willis, Brian H. and Clarke, Aileen (2021) Faecal calprotectin testing in UK general practice : a retrospective cohort study using The Health Improvement Network database. The British Journal of General Practice, 71 (712). e854-e861. doi:10.3399/BJGP.2021.0125 ISSN 0960-1643.

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Official URL: https://doi.org/10.3399/BJGP.2021.0125

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Abstract

Faecal calprotectin (FC) testing to detect inflammatory bowel disease (IBD) was recommended for use in UK general practice in 2013. The actual use of FC testing following the national recommendations is unknown. To characterise the use of FC testing for IBD in UK general practice. A retrospective cohort study of routine electronic patient records from The Health Improvement Network database from UK general practice. The study included 6 965 853 adult patients (aged ≥18 years), between 2006 and 2016. FC test uptake, the patients tested, and patient management following testing were characterised. A total of 17 027 patients had 19 840 FC tests recorded. The mean age of tested patients was 44.2 years. The first FC tests were documented in 2009. FC test use was still increasing in 2016. By 2016, 66.8% ( = 493/738) of practices had started FC testing. About one-fifth (20.7%, = 1253/6051) of tests were carried out in patients aged ≥60 years. Only 7.8% ( = 473/6051) of the FC test records were preceded by symptoms eligible for FC testing. Only 3.1% ( = 1720/55 477) of patients with eligible symptoms have received FC testing since the national recommendations were published. There was only a small number of patients with symptoms, FC test, and a IBD diagnosis. In total, 71.3% ( = 1416/1987) of patients with a positive and 47.7% ( = 1337/2805) with a negative FC test were referred or further investigated. Uptake of FC testing in clinical practice has been slow and inconsistent. The indication of non-compliance with national recommendations may suggest that these recommendations lack applicability to the general practice context.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Inflammatory bowel diseases, Inflammatory bowel diseases -- Diagnosis, Colonoscopy
Journal or Publication Title: The British Journal of General Practice
Publisher: Royal College of General Practitioners
ISSN: 0960-1643
Official Date: 4 October 2021
Dates:
DateEvent
4 October 2021Published
11 June 2021Accepted
Volume: 71
Number: 712
Page Range: e854-e861
DOI: 10.3399/BJGP.2021.0125
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 6 December 2021
Date of first compliant Open Access: 6 December 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
DRF-2016-09-038[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Applied Research Collaboration (ARC) West Midlands[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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