Lipid Testing for People with Cardiovascular Disease
Lipid testing is a key component of cardiovascular risk assessment and modification. We hope this new ‘Express Audit’ will help you reflect on your use of these important tests. If you identify a gap in your practice, we would encourage you to work through the continuous quality improvement cycle outlined on the back page. This ‘Express Audit’ is endorsed by the RNZCGP as a CQI activity. This means you can claim MOPs points for each cycle of this audit that you complete. Please note the audit is now out of date and no longer available.
Nitrolingual spray is used almost exclusively for the management of angina. People with angina have a five year cardiovascular risk of >20% and will benefit from lipid modification no matter what the levels. It is recommended these people have annual cardiovascular risk assessment including annual fasting lipid testing.
These graphs suggest three things to us:
- Approximately 30% of people on Nitrolingual spray are not receiving annual lipid testing.
- There is a small but consistent difference between lipid testing rates between males and females, even though all already have ischaemic heart disease and are at high risk.
- The rate of lipid testing falls off significantly over the age of 75 years.The decrease in testing over the age of 75 years demonstrates the pragmatic approach GPs take. There is little evidence for lipid testing above this age and it appears that the combined wisdom of our GPs is to consider discontinuing testing above this age.
Cardiovascular risk assessment is recommended for all European males 45 years or older, European females 55 years or older, Māori and Pacific Peoples males 35 years or older, Māori and Pacific Peoples females 45 years and older, Asians 45 years or older.
Time Period 1 March 2006 - 31 May 2007.
Patients were assigned to you if they were dispensed a nitrolingual pump spray on a prescription with your NZMC number within the time period 1 June 2005 to 31 May 2007.
Lipid testing or statin prescriptions may have been supplied by other prescribers.
Data has been excluded where the NZMC or NHI number was not recorded.
Graphs three to five depict ages ≥ 45 except: European - Female(≥55); Māori and Pacific Peoples - Male (≥35). Please note the upper age limit for graphs four and five is 75 years.
Any Patients that died within the time period were excluded.
Population data: Estimated National Ethnic Population by Age and Sex as at 30 June 2006 retrieved October 26, 2007 from http://www.stats.govt.nz/tables/population-estimates.htm