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Original research
What is the current provision of service for gastrostomy insertion in England?
  1. Heather Parr1,
  2. Elizabeth A Williams2,
  3. Sean White3,
  4. Nick Thompson4,
  5. Mark E McAlindon1,
  6. Andrew D Hopper5,
  7. Alistair McKinlay6,
  8. David Surendran Sanders1
  1. 1Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  2. 2Department of Oncology & Metabolism, The University of Sheffield Medical School, Sheffield, UK
  3. 3Home Enteral Feeding Dietetics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  4. 4Gastroenterology, Freeman Hospital, Newcastle upon Tyne, UK
  5. 5Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
  6. 6Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK
  1. Correspondence to Dr Heather Parr, Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; h.parr{at}nhs.net

Abstract

Background Significant morbidity and mortality can be associated with gastrostomy insertion, likely influenced by patient selection, indication and aftercare. We aimed to establish what current variation in practice exists and how this has improved by comparison to our previously published British Society of Gastroenterology survey of 2010.

Methods We approached all National Health Service (NHS) hospitals in England (n=198). Email and web-based questionnaires were circulated. These data were correlated with the National Endoscopy Database (NED).

Results The response rate was 69% (n=136/198). Estimated Percutaneous Endoscopic Gastrostomy (PEG) placements in the UK are currently 6500 vs 17 000 in 2010 (p<0.01). There is a dedicated PEG consultant involved in 59% of the centres versus 30% in 2010 (p<0.001). Multidisciplinary team meeting (MDT) discussion occurs in 66% versus 40% in 2010 (p<0.05). Formal aftercare provision occurs in 83% versus 64% in 2010 (p<0.001). 74/107 respondents (69%) reported feeling pressurised to authorise a gastrostomy.

Conclusion This national survey, validated by the results from NED, demonstrates a reduction of over 60% for PEG insertion rates compared with previous estimates. There has also been an increase in consultant involvement, MDT discussion and aftercare provision. However, two-third of responders described ‘pressure’ to insert a gastrostomy. Perhaps further efforts are needed to include and educate other specialty teams, patients and next of kin.

  • endoscopic gastrostomy
  • gastrostomy
  • nutrition support
  • enteral nutrition
  • quality of life

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors DSS conceived the study. DSS and HP designed the initial study and are guarantors. All other authors then contributed to any further study design, data analysis and revision of initial draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.