507 Assessing the Standard of Referral Letter Documentation and Outcomes of Claudicants in the Vascular Outpatient Clinic

Aim Referrals to the vascular outpatient clinic are made by GPs and Allied Health Professionals (AHPs), who may not have prior vascular training. We assessed standards of referral letters with associated clinic outcomes. Method Referral letters for new patients attending clinic 01/01/2023-31/08/2023 were reviewed for intermittent claudication (IC) diagnosis along with referral urgency and referring clinician grade. Documentation of IC distance, pulses, cardiovascular risk factors (CVSRF), antiplatelet and statin prescriptions were assessed as minimum standard. Results 141 (GP:111,AHP:30) new IC patients were reviewed in clinic: 72.3% male, mean age 71.2(SD:10.5) years. 100 were referred as routine, 33 urgent and 8 not specified. 86(61%) referral letters recorded claudication distance (47(54.7%) <100m, 39(45.3%) >100m). GPs and AHPs had no differences in documentation for ≥1 CVSRF (71(64%) vs 19(63.3%), p=0.949), antiplatelet prescription (43(38.7%) vs 10(33.3%), p=0.588) and statin prescription (60(54.1%) vs 16(63.3%), p=0.944). 100(70.9%) referrals had documented pulses, with no difference between GPs and AHPs (81(73.6%) vs 19(63.3%), p=0.302). No differences in referral urgency were found related to pulse assessment in community. Patients with IC distance <100m were more likely to be referred for further investigations than >100m (21(45.6%) vs 7(17.9%), p=0.008). Conclusions Walking distance <100m on referrals was the only factor associated with further clinic investigations. Therefore, we are developing an IC management flowchart for the integrated care board with distance >100m to be managed in the community with best medical therapy/exercise, and <100m to be referred for clinic assessment.