April 2001

 

BEECHWOOD SURGERY

NEWPORT

SOUTH WALES

To audit the current level of cholesterol control in patients with Ischaemic Heart Disease who are currently taking lipid lowering medication.

 

Criteria: Patients to have a confirmed diagnosis of IHD

To be currently on repeat prescription for lipid lowering

Medication

 

Standard: To maintain cholesterol level to below 5mmol (LDL to < 3mmols)

Or by 30% whichever is the greater

As per N.S.F framework – Coronary Heart Disease

 

A computer search revealed that 191 patients with a diagnosis of ischaemic heart disease are currently prescribed lipid lowering medication.

Of these: MALE ® 121

> 191

FEMALE ® 70

 

For the purposes of this audit only the male population was considered, and of these 25% (30) were selected at random to audit current cholesterol level control.

Of the 121 men:

of the remaining 44 patients

 

Statins/Fibrates currently used:

 

Of the 25% i.e. 30 patients taken from the search to assess cholesterol maintenance level – the last recorded result showed the following

 

 

Cholesterol level < 5.0mmol = 22 patients

4.5 – 4.9mmol = 12

Of these: 20 attended IHD Clinic

4.0 – 4.4mmol = 7 > 1 attends the Diabetic Clinic

< 3.9mmol = 3 1 attends neither

 

 

 

Cholesterol level > 5.0mmol = 8 patients

 

3 x IHD Clinic patients ® 1. 5.6mmol – has had statin increased, due follow up

2. 5.6mmol – " " " " " " "

3. 5.2mmol - " " " " " " "

 

3 x Diabetic patients ® Surgery – 6.6mmol

5.6mmol - also under care of RGH

 

2 x c/o RGH ® Cardiologist 5.7mmol

x 1 ? no record in surgery notes – did not reply to IHD invitation

 

 

 

Conclusion/Forward Planning

 

 

  1. It would appear that the main serum cholesterol levels are being maintained within N.S.F guidelines

    2.  

     

  2. Follow-up required as planned for IHD patients on increased statin

    3.  

     

  3. Offer invitation to attend the IHD Clinic to those patients identified as not

    4. under any review

     

     

  4. GP to possibly consider cholesterol levels for those patients identified with

    5. having present levels > 5.0mmol

     

     

  5. GP to review patients medication history ref: being prescribed Simvastatin

for one month only