Third party funding for Fecal Calprotectin is likely to reduce colonoscopy usage in Australia: Gastroenterologists' use and knowledge of its role in clinical practice
Date
2014
Authors
Elnawsra, O.
Fok, I.
Connor, S.
Sparrow, M.
Gibson, P.
Andrews, J.M.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Conference item
Citation
Journal of Gastroenterology and Hepatology, 2014, vol.29, iss.Suppl. 2, pp.107-108
Statement of Responsibility
Omar Elnawsra, Ian Fok, Susan Connor, Miles Sparrow, Peter Gibson, Jane Andrews
Conference Name
Australian Gastroenterology Week (AGW) (22 Oct 2014 - 24 Oct 2014 : Gold Coast, Queensland)
Abstract
Background:Fecal calprotectin (FC) has emerged as a reliable means ofdistinguishing between irritable bowel syndrome (IBS) and inflammatorybowel disease (IBD) and as a measure for activity of IBD. However colonos-copy is still the predominant test used by gastroenterologists in these settings.This preference may be influenced by funding and availability of each of thesetwo techniques. The aim of this study was to investigate the current & desired use of FC by Australian gastroenterologists (GEs), and to elicit factors whichreportedly affect physicians’ choices. They were also asked specificallywhether (external third party) Medical Benefits Schedule (MBS) fundingwould influence their use of FC (either frequency or indication).Methods:Electronic surveys were sent out to 405 consultants and 34registrars in Australia (n=439). Respondents who answered less than 50%of the survey were excluded from analysis.Results:172 participants provided a>50% response (39% response rate):32.7% of respondents were from Victoria, 28% NSW and 20.7% Queen-sland, with the remaining 18.6% in SA, WA, TAS and ACT. Most (71%)reported using FC in their clinical practice. The percentage of users washighest in Queensland (88% of Qld respondents), followed by Victoria(76%), while only 50% of respondents from NSW used FC. Amongstresponders from the other states, overall 88% were users (range 100% WAto 75%ACT). Factors cited by non-users in restricting FC use included; cost(20%), availability (48%) and familiarity (22%) of/with the test. Evenamongst users, 64% cited funding as a major deciding factor for theuse/non-use of FC. Consistent with published literature, 98% and 86% of FCusers believed that the test is a reliable method of differentiating betweenIBD and IBS and assessing for mucosal healing in IBD respectively. Mostnon-users would use FC to differentiate IBD from IBS (78%) and to assessfor mucosal healing in IBD (58%) if FC was supported by third partyfunding. Both users (81%) and non-users (67%) of FC reported that the useto defer or avoid colonoscopies was likely if the test were MBS funded,however most (90% users of FC; 94% of non-users) stated that FC shouldnot be a substitute for specialist clinical consultations. The bulk of respon-dents (86% of users; 66% of non-users) agreed that third party health fundedFC testing would improve gastroenterological practice in Australia.Conclusion:Australian GEs are well educated about the role of FC andwould use it to better target colonoscopy resources should it be funded.This study highlights the importance of MBS funding of FC and its benefitsfor gastroenterology practice. FC use in Australia shows substantial geo-graphical variation. This appears to be related to different state basedaccess to FC funding and variability in test familiarity possibly due to thegeographical variation in the location of large IBD centers.
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Dissertation Note
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© 2014 The Authors. Journal of Gastroenterology and Hepatology © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd