Endocrine Abstracts

Background: Adrenal incidentalomas (AI), the finding of asymptomatic adrenal lesion on unrelated imaging, represent an increasing number of endocrine referrals. In 2022, we introduced a nurse-led pathway to manage AI.

Aim: To assess the cost savings and patient experience of a telephone nurse-led AI service at Musgrove Park Hospital.

Methods: Records for patients seen in the AI clinic from 1/4/22 to 1/4/23 were assessed. The clinical outcome, number receiving consultant follow up and resultant cost saving were calculated. Subsequently, 10 of these patients were randomly selected and asked for feedback via telephone consultation. They were asked to score out of 5 questions relating to their satisfaction with the service, understanding of why they were contacted, ease of the biochemical tests and knowledge of who to contact with further questions.

Results: 104 patients were referred through the AI pathway during the 12 months. 54 required a further characterisation scan. 58 patients were discharged with telephone specialist nurse appointments only. 28 patients have not attended or are awaiting biochemical test results. 18 patients were referred on to be seen by a consultant or registrar in clinic. This resulted in a provisional cost saving of 20%, which is likely to be closer to 25% when outstanding patients results are reviewed. Of the 10 patients interviewed, there was a high degree of satisfaction (n=4.2, where n is the average score out of 5 for the question), and patients generally understood why they were being contacted (n=4.1). The biochemical tests were also broadly thought to be easy to undertake (n=4.3). Fewer patients were certain who to contact with further questions (n=3.0).

Conclusion: A nurse led clinic is a method for managing AI referrals that is both cost-effective and convenient for patients. Increased information on who to contact if there are questions can be provided.