ESPE Abstracts

We conducted a quality improvement project in our centre to assess the screening process for hypertension in annual review clinics. All children with diabetes should have their BP checked at least once a year and it should be plotted against their age, gender and height centile to calculate BP centile to determine if their BP is within normal range or high. Hypertension is defined BP >95th centile for age and height centile. These children should be monitored and subsequently treated if high BP persists in order to avoid long term complications of diabetes. Children over 12 years of age with diabetes were included in study who had their annual review between October to December 2022. 53 children met the inclusion criteria and included in study. 87% of the children had BP checked on their annual review but 13% did not. Out of those where BP was measured, only 7% of the patients had their BP centile documented on clinical notes. It was interesting to note that only 55% patients with B P >95th centile were picked up in annual review clinic and 45% were missed. Patients who were detected to have high BP had a variable follow up. Based on the findings of this study, we proposed to include BP centile calculator on our electronic patient record which will automatically calculate BP centile based on height, age and gender. This will allow clinicians to review this information quickly without having to look at BP centile charts which sometimes can be a reason of not checking centiles due to time constraints(based on feedback from clinicans). We expect this intervention will improve detection of high BP in clinics. We updated our trust guideline for detection and treatment of hypertension in children with diabetes so clinicians have a pathway to arrange follow up. We aimto re-audit in 6 months after the changes have been implemented to assess the outcome of our intervention in improving pick up rate of hypertension in diabetes annual review clinics.