RT Journal Article
SR Electronic
T1 Should diverticulitis be managed in primary care? An audit on the management of diverticulitis in primary care.
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP bjgp20X711665
DO 10.3399/bjgp20X711665
VO 70
IS suppl 1
A1 Miraen Kiandee
A1 Rajani Sripada
YR 2020
UL http://bjgp.org/content/70/suppl_1/bjgp20X711665.abstract
AB Background The prevalence of diverticulosis and acute diverticulitis is increasing in developed countries. For those with diverticulosis the lifetime risk of developing acute diverticulitis is about 4–25%. Mild, uncomplicated diverticulitis can be, and often is, managed safely in a primary care setting, avoiding unnecessary admission.Aim To evaluate management of suspected diverticulitis in primary care against standards set by the National Institute for Health and Care Excellence (NICE) and review admission rates following primary care management.Method An electronic search on EMIS Web using Read codes ‘diverticulitis’, ‘diverticulosis’, and ‘diverticular disease’, with a specified period of 2017–2019. All consultations with suggestions of an infective flare of diverticular disease were included in the study. Clinical data from the consultations were extracted and retrospectively audited.Results A total of 64 patients were identified with diverticular disease or diverticulosis. Of those, 42% (n = 27) presented to primary care with presenting complaints suspicious of diverticulitis. A total of 64 consultations were reviewed, as several patients presented more than once in the study period. Of the consultations reviewed, 12.5% (n = 8) resulted in referral to the surgical assessment unit. Antibiotics were prescribed after 68.4% (n = 39) of consultations. Bloods for inflammatory markers were performed after 19.3% (n = 11) of consultations. Only 3.5% (n = 2) of patients were reviewed within the recommended 48-hour timeframe. Only 3.5% (n = 2) of patients subsequently deteriorated and required admission.Conclusion The management of diverticulitis in this primary care centre is not fully concordant with NICE guidelines. There is a need to improve adherence, in particular antibiotic regimen when deciding to prescribe antibiotics.