Introduction Once remission is induced, the majority of patients with mild to moderate UC are managed in primary care on long term 5 ASA maintenance therapy. Lack of adherence to therapy has significant implications for patients with an impact on the use of NHS resources.
The aim was to assess the management of patients with mild to moderate UC on 5 ASA maintenance therapy in primary care.
Methods All UC patients on 5 ASA therapy from 31 practices covering three CCGs in were identified and invited to attend a clinic at their practice. Disease location, activity (Walmsley Index), 5 ASA dose and frequency and adherence to therapy were recorded.
Results 481 UC patients were identified, 212 reviewed and 158 patients (M:F = 99:59) fully assessed. Age (mean [range]; 60.6 [22–88 yrs.] yrs.). UC subclass (No [%]): proctitis 23 [14%]; distal colitis: 59 [39%]; pan colitis: 38 [24%]; UC unspecified:38 [23%]. 58% on Asacol; 30% on Pentasa and 9% on Mezavant respectively. Maintenance dose range 1–6.4 g/day; 29% were on lower than the recommended dose for their specific 5 ASA. 48 (31%) received other therapies (azathioprine, steroids or mesalazine enemas). Walmsley Index (mean 2.3) was ≥4 in 27 patients (17%) indicating flare. 27 patients (17%) had symptoms and 39 (29%) had adherence issues. Several patients missed routine surveillance colonoscopy and blood tests.
Conclusion UC is inadequately managed in primary care
Disclosure of Interest D. Aldulaimi: None Declared, D. Farmer: None Declared, H. Prasher: None Declared, R. Jazrawi Conflict with: Dr R Jazrawi is medical Director of Dr Falk Pharma UK
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