P1614 - Real World Assessment of Factors Influencing Fecal Calprotectin Test Completion Rates

Benjamin Yeager, MD¹, Jay Shah, ², Edward Oldfield, MD¹, Esteban Figueroa, MD^3
1University of Virginia Health System, Charlottesville, VA; ²University of Virginia, Charlottesville, VA; ³University of Virginia Digestive Health Center, Charlottesville, VA

Introduction: Fecal calprotectin (FC) tests are noninvasive markers of colonic inflammation shown to correlate with endoscopic and histologic colon inflammation in patients with inflammatory bowel disease (IBD). In practice, barriers to stool sample collection can delay test results and subsequently impact patient care. We conducted a quality improvement initiative to assess FC completion rates and identify potential barriers to completion within our institution.

Methods: We conducted a retrospective chart review of patient visits in our IBD specialty clinic with outpatient FC tests ordered between 1/1/2021 to 5/31/2021. Information collected included patient age, disease type, city of residence, FC completion status, days between order and collection, and location of processing laboratory.

Results: Overall, 192 FC tests were ordered during the study period with an overall completion rate of 46%. A total of 110 (57%) tests were ordered from office visits and 82 (43%) from remote visits. Office visits had a significantly higher completion rate than remote visits (69% and 31% respectively, p = 0.0036). Patients with a previous FC test had a higher, though not significant, completion rate than patients performing their initial test (32% and 28% respectively, p=.34). The mean time to collection was 5 days. There was no significant difference between completion rates based on patient distance from our institution or location of laboratory processing.

Discussion: Our results confirm suboptimal completion rates of FC testing, which have been reported as low as 37%. The overall low completion rate is likely affected by the need for patient stool collection and drop off at a laboratory, in addition to a lack of patient education surrounding the significance of the test. We surmise that the significantly lower completion rate in remote visits is likely due to a combination of the inability to provide stool collection kits during the visit, offer same-day in-clinic stool collection, or provide face to face education. Additionally, our analysis was performed in an IBD specialty clinic where nurses are experienced and trained in counseling patients on the FC test in comparison to other GI or medical specialties. As part of our quality improvement initiative, our initial planned intervention to increase completion rates is to implement a nurse navigator to place reminder phone calls and send electronic messages after the visit.



Disclosures:


Benjamin Yeager, MD¹, Jay Shah, ², Edward Oldfield, MD¹, Esteban Figueroa, MD³. P1614 - Real World Assessment of Factors Influencing Fecal Calprotectin Test Completion Rates, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.