P38 Evaluating compliance to thiopurine monitoring guidelines in paediatric inflammatory bowel disease

Aim Paediatric inflammatory bowel disease (IBD) accounts for 7–22% of IBD cases globally and there is evidence to suggest that the incidence rising. 1 The aims therapy in paediatric are relieve symptoms, optimize growth, improve quality life while minimizing drug toxicity reducing risk complications without surgery. Treatment involves two main steps, inducing remission maintaining remission. Thiopurines effective at but have serious adverse effects, such as myelosuppression hepatotoxicity, 2 therefore, patients on thiopurines must regular monitoring ensure safe prescribing. Several national international guidelines been created recommending parameters thiopurines. At our trust we follow British Society Gastroenterology, Hepatology Nutrition (BSPGHAN) guidelines. 3 primary aim this study was evaluate compliance BSPGHAN initiating a tertiary gastroenterology unit. Method were identified using pharmacy dispensing system. Subsequently, patient electronic records accessed collect demographics data comparing guideline. state should thiopurine methyl transferase screen, FBC, LFT documented counselling before thiopurines, with subsequent metabolite specific frequencies maintenance therapy. Data analysis performed ways. Firstly, overall guideline assessed by examining each criterion. Secondly, percentage scores generated assess variation between patients. Mann-Whitney U test compared sexes used Kruskal-Wallis phenotypes. Results Compliance all criteria less than 100%. Percentage ranged from 44.4% 100%, median 88.9% interquartile range 77.8% generally higher undertaken initiation treatment, lowest level score 61% seen requirements 12-week interval post treatment. Only 56 (37.3%) had Statistical difference not observed sex, phenotype. Conclusion Suboptimal noted trust, suggesting improvements need be made comply recommended results consideration more simplified regimen routine considered, National Formulary (BNF). warrants further investigation identify possible causes variation. References Auvin S, Molinié F, Gower-Rousseau C, Brazier Merle V, Grandbastien B, et al . Incidence, clinical presentation location diagnosis disease: prospective population-based Northern France (1988–1999). Journal Gastroenterology [Online] Lippincott Williams Wilkins; 2005; 41 (1):49–55. Available from: doi:10.1097/01.MPG.0000162479.74277.86 Formulary. Azathioprine [Online]. https://bnfc.nice.org.uk/drugs/azathioprine/ [Accessed May 2022] Working group Thiopurine (Azathioprine/Mercaptopurine) Blood Monitoring Guidelines. 2018. https://bspghan.org.uk. January