Cardiovascular Improvement Audit

1. Cardiovascular Improvement Audit Midlands Health Network Gary Jackson Dyfed Thomas Allan Moffitt Michelle Bayley

2. What were we aiming to do? • Audit the secondary prevention of cardiovascular disease (CVD) patients with the aim to improve the management of those patients • Foster quality improvement • Improved health and equity • Strong evidence around the benefit of treatment in those with established CVD • Some evidence of lack of coverage for statins (Thornley et al 2011)

3. How did we do it? • Identification of all current patients with CVD related hospital admission between 1 Oct 2001 and 31 May 2011 • Of those people, who had been dispensed a statin or antihypertensive in the 4 months June 2011 – Sep 2011 • Details to practices for those not dispensed to audit the reasons for this

4. What did we achieve? • 10,366 patients with CVD hospitalisation • 85% dispensed antihypertensive • 78% dispensed statin • 72% dispensed both statin and antihypertensive • The majority (74%) of patients not on medication had a specified reason

5. What were our successes? • Methodology allows virtually 100% coverage of patients with past CVD hospitalisation • Audit suggests high existing coverage for secondary prevention medication • 59% response rate for audit of those not on medication – good acceptance by practices • Areas of improvement able to be identified and quantified

6. Other observations • Accuracy of hospital ICD10 coding good • Some GPs were treating by individual risk factors • Some confusion over which diagnoses warrant secondary prevention • No record of hospital admission for some patients • Differences in reasons for no prescription

7. What might we do differently? • Include deceased patients • Widen criteria to include angina • Refine the spreadsheet • Re audit in one year to see size of change