Endocrine Abstracts

Individuals with chronic hypoparathyroidism sometimes receive suboptimal care with high frequency of unplanned hospitalisation and iatrogenic harm. In 2015 the European Society for Endocrinology published evidence base consensus guidelines on the management of chronic hypoparathyroidism. Using these consensus recommendations as audit standards we worked with the Society for Endocrinology and Parathyroid UK to conduct a national audit of management of chronic hypoparathyroidism in UK endocrine departments during the second half of 2020. Endocrine leads in 117 endocrine departments were written to inviting participation in the survey by completing a data collection tool on up to 5 sequential cases of chronic hypoparathyroidism seen in their department’s outpatient clinics in the previous 6 months. Responses were received from 22 departments giving a response rate of 18.8% with each department contributing data on between 1 and 5 cases. A total of 80 valid returns were received. The main findings were that 62.5% of returns were compliant with the treatment standard that all cases should be treated with activated vitamin D and calcium supplementation and 60% with the standard that all should be supplemented with vitamin D. For monitoring standards, compliance rates were 63.8% for 3-6 monthly monitoring of renal function; 80% for 3-6 monthly monitoring for symptoms of hypocalcaemia; 23.8% for annual assessment of 24 hr urinary calcium excretion and 20% for renal imaging. We conclude that improvements in the UK national standard of management of chronic hypoparathyroidism could be made and that this will benefit both quality of life, morbidity and potentially mortality in this group of patients. Additionally, it may also benefit NHS services by reducing the number of unplanned hospital admissions of individuals with chronic hypoparathyroidism. We are indebted to those colleagues who generously gave their time to complete the data returns during a very difficult year in the NHS.