P87 The IBD registry as a platform for steroid therapy audit: time trends in treatment duration

Introduction Oral corticosteroids continue to play a key role in inducing remission in inflammatory bowel disease (IBD) but are not effective as maintenance agents. Avoiding prolonged courses of treatment is an important strategy to minimise side effects. The UK IBD Registry has established an infrastructure capable of recording prescribing at point-of-care using a range of different local systems and software, including direct capture from local operational records. We investigated the feasibility of extracting data to undertake audit of steroid prescribing for hospitals participating in the Registry. Methods Data submitted to the UK IBD Registry were analysed over three consecutive fiscal years (2016/17, 2017/18 and 2018/19). All prescriptions for oral steroids (prednisolone or budesonide) with a record of both a start and stop date were extracted and linked to patient characteristics. We compared the mean duration of steroid courses initiated in each year and the proportion lasting eight weeks or less. Results There were 2,156 prescriptions (prednisolone 83%; budesonide 17%) with a start and stop date, relating to 1,591 patients treated at 42 hospitals. Three quarters (77.4%) of cases had a single steroid prescription recorded over the three year time period (5.8% had >2). Results are summarised in the table 1. There was a year-on-year reduction in the mean duration of recorded steroid courses from 13.0 to 8.4 weeks (p Conclusion IBD teams participating in the UK IBD Registry have achieved a reduction in the duration of steroid treatment courses, suggesting progress in efforts to avoid prolonged steroid exposure. The Registry has established an infrastructure capable of serving as a platform for future nationwide prospective steroid audit.