SFEBES2009 Poster Presentations Thyroid (45 abstracts)
Department of Diabetes and Endocrinology, Scunthorpe General Hospital, Scunthorpe, UK.
Introduction: A joint RAI clinic, led by an endocrinologist and nuclear physicist, was introduced in our centre, in July 2007.
Aims: To compare our practice since the introduction of the joint RAI clinic against guidelines from the Royal College of Physicians of London.
Methods: A retrospective audit of patients who received RAI, Sept 2007Oct 2008. Data collected from patients case notes and compared to previous audit 20042007.
Results: Seventy-six episodes of RAI therapy, patients average age 56 years, 75% females, 55.2% had Graves disease and 43.4% received primary RAI. On comparison with the previous audit there was a 200% increase in the number of patients who were treated with RAI (36 vs 72 per year). Cure, defined as hypo or euthyroidism at 6 months was similar at 80.2 vs 82%. Duration from diagnosis to cure for primary RAI was 16.2 vs 41.6 months for secondary RAI.
Since the introduction of the Joint clinic more patients received adequate information prior to treatment in the form of leaflets (100 vs 66%) and warning cards (100 vs 1%). Duration from referral to RAI administration has significantly reduced from 4.8 months to 18.4 days. Other main differences are highlighted in Table 1.
Audit period | Nov 2004Aug 2007 | Sep 2007Oct 2008 |
Number of patients | 92 | 76 |
Primary RAI | 37% | 43.4% |
Signed consent form | 28% | 100% |
Pregnancy test documented | 22% | 89% |
FU in clinic within 48 weeks post RAI therapy | 64% | 79% |
Letters sent to the GP within 2 weeks | 16% | 69% |
Conclusions: The joint RAI clinic has led to promotion of radioiodine therapy; better informed patients and subsequently more adherent to radiation protection precautions; reduction in patients treatment journey; and better communication between secondary and primary care.
Primary RAI therapy is associated with reduced patients journey from diagnosis to cure.