Endocrine Abstracts (2015) 38 FP10 | DOI: 10.1530/endoabs.38.FP10

A dedicated Turners clinic improves adherence to UK recommended best practice and is well liked by patients

Jean Munday, Anjana Siva, Huw Thomas, Lisa Cross, Michelle Evans, Kim Page, Eleni Karathanasi & Lorraine Albon

Queen Alexandra Hospital, Portsmouth, UK.

Background: Prior to 2014 Portsmouth patients with Turners syndrome (TS) were seen in a variety of endocrine clinics. Screening investigations e.g. cardiac echo, necessitated further appointments. The Turners Syndrome Support Society (TSSS) recommend that ladies should be under the care of a specialist multi-disciplinary TS clinic, equipped to manage the specific medical problems associated with the syndrome.

Innovation: Portsmouth Endocrine Department established a dedicated Turners MDT clinic staffed by Consultant Endocrinologist and nurse specialist. Liaison with cardiology and audiology led to provision of same day echocardiography and audiological tests. Patients attend for the whole morning arriving together. 30 minutes are spent discussing a relevant topic, subsequently patients have their screening tests and consultant review.

Audit: We reviewed the notes of all patients with TS registered on our database. Compliance with recommended monitoring pre dedicated clinic. Compliance with recommended monitoring post clinic inception. Patient satisfaction survey sent to all participants. Repeated non attenders were excluded.

Results: A marked improvement was seen in adherence to recommended monitoring as per the TSSS checklist after establishment of the clinic. Satisfaction survey results were overwhelmingly positive. Women appreciated having all investigations on the same day, and enjoyed meeting and talking to others similarly affected.

Screening testBefore joint clinic (%)After joint clinic (%)
Annual blood tests65100
Audiology test5090
DEXA scan3580
Thyroid autoantibodies20100
Coeliac antibodies35100

Future plans: Our cohort size suggests we are not seeing all affected women in our catchment area. The joint clinic has been advertised to local GPs raising awareness of TS and the recommended screening schedule. Additionally, we have recognised the frequency of abnormal liver function tests in this group, thus a Hepatologist will join the team providing same day fibroscans and review.

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