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Improving care pathways

Improving care pathways – Eosinophilic oesophagitis (EoE)

In partnership with patient and NHS organisations we have developed an eosinophilic oesophagitis (EoE) integrated care pathway, a costed integrated patient scenario, prescribing guidance and a shared care protocol. Supporting this content we have created an infographic and videos to explain EoE causing food bolus obstruction to raise awareness of the condition, cover the impact it has on patients and the health service and provide guidance on the optimal management as determined by a consensus group of clinicians.

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What is eosinophilic oesophagitis?

Eosinophilic oesophagitis (EoE) is a chronic inflammatory condition of the oesophagus, in which the body overproduces a type of white blood cell called eosinophils, leading to inflammation in the oesophagus.1,2

Patients with EoE typically have the condition for many years and symptoms can be unpleasant and socially embarrassing and have a significant impact on quality of life.2

Once initially regarded as a disease of younger people, EoE is now known to present at any age. The incidence rises during adolescence and peaks in early adulthood.3 In about one third of people, the first episode of EoE is an acute food bolus obstruction,1 requiring emergency hospital attendance.

Failure to diagnose and effectively treat eosinophilic oesophagitis is a barrier to optimal patient care

It is clear that failure to diagnose EoE in patients presenting to accident and emergency (A&E) is a serious barrier to optimal patient care, resulting in a cycle of persistent episodes of food bolus obstructions. 

References:

  1. Dhar A, Haboubi HN, Attwood SE, et al. British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Gut 2022;71:1459–87.
  2. National Institute for Health and Care Excellence (NICE). Budesonide orodispersible tablet for inducing remission of eosinophilic oesophagitis. Available at: https://www.nice.org.uk/guidance/ta708. Accessed February 2024. 
  3. Dellon ES. Eosinophilic esophagitis (EoE). Available at: www.med.unc.edu/medicine/news/chairs-corner/podcast/eoedellon. Accessed February 2024.

View our integrated care pathway for eosinophilic oesophagitis (EoE) through the window below. This pathway document has been developed based on the consensus of expert groups and sets out an optimal pathway based on recommended best practice for the management of EoE. It behoves clinicians in primary care and each hospital trust to put this into practice – the sooner the better, given how quickly the incidence of EoE is rising.

 

View below our two video explainers on eosinophilic oesophagitis and how it can be managed effectively with experts from the field including Stephen Attwood, Professor of Health Services Research at Durham University, Amanda Cordell, CEO and Founder of EOS Network Charity, and Hasan Haboubi, Consultant Gastroenterologist, Cardiff & Vale University Health Board.

What is eosinophilic oesophagitis (EoE)?

 

View our video explainer covering what is eosinophilic oesophagitis, how prevalent is it, what the patient journey looks like and how and where patients present with symptoms of the disease.

Effective management of eosinophilic oesophagitis (EoE) to improve patient care

View the below video to understand what needs to be done to treat patients with EoE more effectively and how the journey for patients with EoE needs to change to improve the experience and outcomes of patients.

Our portfolio of work

Wilmington Healthcare has been working to optimise NHS patient pathways in eosinophilic oesophagitis (EoE). Our work has been developed with the guidance of expert clinical groups to establish optimal diagnosis and treatment pathways to improve the standard of care for patients presenting and living with EoE.

EoE integrated care pathway

(Downloadable version - Open with specialist PDF viewer, such as Adobe for full interactivity.)

Developed based on consensus of expert groups, this document sets out an optimal pathway based on recommended best practice for the management of EoE. It behoves clinicians in primary care and each hospital trust to put this into practice – the sooner the better, given how quickly the incidence of EoE is rising.

PDF

EoE integrated care pathway (portrait poster)

This pdf maps out a summarised version of the optimal pathway for EoE as determined by the consensus of expert groups in an easy-to-follow portrait layout.

PDF

Patient Scenario: Nathan’s story of undiagnosed EoE causing food bolus obstruction

Developed by a group of experts, Nathan’s story sets out a journalistic-style case of a patient with EoE, highlighting the current suboptimal/typical pathway of a patient verses the optimal pathway. It demonstrates the impact of the condition on the personal and clinical journey of the patient, highlighting the positives and negatives of both pathways and the cost implications of each over a five-year period.

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Eosinophilic oesophagitis (EoE) infographic

Infographic outlining what is EoE, the burden, how people present, diagnosis and treatment.

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Shared care protocol

A shared care template for the use of budesonide orodispersible tablets for maintaining remission of eosinophilic oesophagitis.

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Formulary application

A formulary application template for budesonide orodispersible tablet (ODT) maintenance treatment, developed by Wilmington Healthcare in conjuction with pharmacy experts.

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Jorveza Formulary Submission Guide

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Jorveza Primary Care Information Guide

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