Endocrine Abstracts

Background: Hyponatraemia occurs in 10- 15% of hospital admissions and is associated with an increased rate of mortality, length of stay in hospital and readmission rates when compared to patients with normal sodium levels. We developed a hyponatraemia algorithm pdf document to all non endocrine general physicians (GPs) in our hospital to aid in managing hyponatraemia effectively. However when we re-audited our practice, these guidelines were rarely used and there was a large variation in care particularly in diagnosing Syndrome of inappropriate AntiDiuresis (SIAD).

Objective: To assess the impact of a novel digital application of a hyponatraemia diagnostic toolkit (https://hyponatraemia.wordpress.com/) that can be accessed via mobile phones for GPs if it will: A) increase the use of the diagnostic algorithm when Sodium is<130 mmol/l B) have an impact on physicians confidence in managing hyponatraemia C) encourage the use of the Bartter-Schwartz (BS) criteria to diagnose SIAD.

Method: A questionnaire survey was sent to GPs before and after the digital application launch of the tool to investigate our objectives. We tracked the internet traffic of the digital tool after its launch.

Results: Twenty three GPs responded to the survey. 68% of responders would start investigating at a level less than 130 mmol/l but this increased to 100% with the digital tool. Mean daily web access of the new tool was 14.3 (0.2 prior to new tool). Mean confidence in managing hyponatraemia increased from 2.4 to 3.7 (scale from 1 to 5, P<0.01 t-test).100% of GPs complied with the BS criteria compared with only 5% prior to the launch.

Conclusion: This novel digital hyponatraemia toolkit was successful in increasing the confidence and awareness for GPs in the management of this common condition. It also helped reduce the large variation in care. The impact of reduction in referrals to the endocrine specialist team are currently being analysed.