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Re-audit on diagnosis and management of Familial H yperlipidaemia

Re-audit on diagnosis and management of Familial H yperlipidaemia. By Dr Rukhsana Hussain June 2012. After 1 st cycle of audit SystemOne autoconsultation created All patients in audit invited for repeat bloods and review with GP by letter

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Re-audit on diagnosis and management of Familial H yperlipidaemia

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  1. Re-audit on diagnosis and management of Familial Hyperlipidaemia By Dr Rukhsana Hussain June 2012

  2. After 1st cycle of audit • SystemOne autoconsultation created • All patients in audit invited for repeat bloods and review with GP by letter • “Hyperlipidaemia” promoted to problem so not missed at follow up appointments

  3. SystemOne Search 11th June 2012 • 53 patients with serum cholesterol 7.5 or more

  4. Exclusions • 29 patients excluded based on age • 1 excluded due to MI – on secondary prevention • 4 patients excluded due to secondary cause of hyperlipidaemia • 2 x alcohol related • 1 x nephrotic syndrome • 1 x uncontrolled hypothyroidism

  5. Demographics • 19 patients total • Age range 31-64 • 10 male • 9 female

  6. Findings • 10 out of 19 patients (53%) were patients from original audit who didn’t respond to letter so no repeat bloods or assessment done • Remaining 9 patients ALL assessed using Simon Broome criteria • All patients had Hyperlipidaemia coded as a problem

  7. Findings • 1 patient referred to lipid clinic - still awaiting outcome • 1 patient fulfilled Simon Broome criteria but declined referral so started on statin • 1 patient already had familial lipoprotein lipase deficiency as per original audit

  8. Review of original Cases • 14 patients from original audit not on second SystemOne search • Reviewed notes • ALL patients had Simon Broome criteria applied • 9 out of 14 (64%) patients cholesterol had improved without treatment • 1 patient had possible FH but refused referral to lipid clinic and started on statin. Her sister actually attended for bloods and was referred to lipid clinic

  9. 1 patient already had mixed hyperlipidaemia • 2 patients had assessment with Simon Broome but didn’t fulfil criteria and Qrisk low • 1 patient didn’t fulfil Simon Broome criteria but started on statin

  10. Conclusions • There has been vast improvement in the use of Simon Broome criteria by clinicians as a result of this audit • Most patients with cholesterol >7.5 did not have familial hyperlipidaemia • It is difficult to get patients to respond to invitations from the surgery especially if they are asymptomatic

  11. Plan • Add patient plan to notes of patients who didn’t respond to invites to allow opportunistic review • Re-audit in 1 year

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