Abstract
Aims: To evaluate the impact of clinical audit and focused interventions on reducing cardiovascular diseases risk by treating Low Density Lipoprotein Cholesterol (LDL-C) in patients with type 2 diabetes attending a primary care clinic in Kuwait.
Methods: Using LDL as a surrogate for cardiovascular risk, the audit team performed a clinical audit with focus on the care process indicator of statin prescription. The basic audit reviewed 100 patients’ medical records retrospectively to assess patients’ lipid profiles and statin prescription. A lipid management protocol and algorithm based on national clinical practice guidelines distributed to all healthcare professionals and was implemented for 3 months followed by re-audit of another 100 records. Descriptive and comparative statistics (pre and post) were performed using SPSS, version 22.
Results: Statin prescription increased significantly from (26%) in the basic audit to (85%) in the post-intervention audit (p<0.001). The mean LDL-C value decreased significantly from 3.37±0.67mmol/L to 2.71±0.79mmol/L, p=<0.001. Mean total cholesterol was significantly reduced from 5.15±0.73mmol/L to 4.68±0.88mmol/L, p=<0.001. Ten years CHD risk decreased from 18.46±11.1% to 16.8±12.23%, p=0.152.
Conclusions: Implementing a clinical audit coupled with focused intervention was successful in improving management of LDL-C among patients with type 2 diabetes mellitus attending the primary healthcare sector in Kuwait.
Methods: Using LDL as a surrogate for cardiovascular risk, the audit team performed a clinical audit with focus on the care process indicator of statin prescription. The basic audit reviewed 100 patients’ medical records retrospectively to assess patients’ lipid profiles and statin prescription. A lipid management protocol and algorithm based on national clinical practice guidelines distributed to all healthcare professionals and was implemented for 3 months followed by re-audit of another 100 records. Descriptive and comparative statistics (pre and post) were performed using SPSS, version 22.
Results: Statin prescription increased significantly from (26%) in the basic audit to (85%) in the post-intervention audit (p<0.001). The mean LDL-C value decreased significantly from 3.37±0.67mmol/L to 2.71±0.79mmol/L, p=<0.001. Mean total cholesterol was significantly reduced from 5.15±0.73mmol/L to 4.68±0.88mmol/L, p=<0.001. Ten years CHD risk decreased from 18.46±11.1% to 16.8±12.23%, p=0.152.
Conclusions: Implementing a clinical audit coupled with focused intervention was successful in improving management of LDL-C among patients with type 2 diabetes mellitus attending the primary healthcare sector in Kuwait.
| Original language | English |
|---|---|
| Pages (from-to) | 259-265 |
| Number of pages | 7 |
| Journal | Primary Care Diabetes |
| Volume | 13 |
| Issue number | 3 |
| Early online date | 19 Dec 2018 |
| DOIs | |
| Publication status | Published - Jun 2019 |
Keywords
- Diabetes
- Low Density Lipoprotein
- Audit
- Clinical guidelines
- Kuwait
