Endocrine Abstracts

Objectives: Improving the management of chronic hypoparathyroidism is crucial for enhancing the quality of life and reducing morbidity and mortality. Our audit assessed the effects of introduction of a dedicated specialist nurse led hypoparathyroidism clinic.

Methods: During 2022 we developed an SOP and undertook training to enable the provision of an endocrine specialist nurse led chronic hypoparathyroidism clinic. The clinic commenced in November 2022 providing protocol driven, consultant supervised, specialist nurse delivered clinical care to a cohort of chronic hypoparathyroidism patients in our large teaching centre service. After the service had been running for 14 months we performed an audit of outcomes in this service. Four treatment standards and nine monitoring standards were used. These standards were derived from the 2015 EJE chronic hypoparathyroidism guidelines as described in our previous national audit of chronic hypoparathyroidism management (Kiam et al 2022).

Results: Over 14 months, 24 individual patients were seen in the service. Each Patient had at least one annual face to face appointment plus remote contact by phone and/or letter as necessary in between appointments. The mean age of patients was 50.25 years and the commonest cause of hypoparathyroidism was post-surgical (100%). Compliance with the audit standards varied between 100% and 63% for the treatment standards and between 96% and 12% for the monitoring standards. Some of the areas of weakness revealed included low rates of 24 h urinary calcium excretion monitoring, serum magnesium monitoring and low rates of renal imaging. In addition, and importantly, 14% of subjects had experienced at least one hospital admission during the audit.

Conclusion: This is a novel model of service delivery for a traditionally under-served population of patients and initial audit outcomes suggest delivery of care standards which are already higher than those seen in our previous national audit of chronic hypoparathyroidism.