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The medical management of stable angina

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The purpose of this report is to compare the medical management of your patients with stable angina with that of your peers. If your prescribing practices are significantly out of line with your peers or the known composition of your practice, then consider if any changes in medical management are appropriate.

People with stable angina are identified as those patients that have received a prescription for sublingual glyceryl trinitrate (spray or tablets) within the past two years (see “Notes” over page for an explanation of exceptions).

It is recommended that all people with stable angina, unless they have contraindications, should be prescribed an antithrombotic medicine (preferably aspirin), a statin and an antianginal medicine. Beta-blockers are recommended as the first-line antianginal medicine. Calcium channel blockers can be used for those unable to tolerate beta-blockers. Long-acting nitrates (isosorbide mononitrate or triglyceryl nitrate patches) are an alternative antianginal treatment for those unable to tolerate beta-blockers or calcium blockers. This report shows the percentage of your patients with stable angina who; have been prescribed an antithrombotic, a statin and a beta-blocker and/or a calcium channel blocker and/or a long-acting nitrate.

People with stable angina are considered to be at very high risk (>20%) of a cardiovascular event in the next five years. Lipid lowering is an important secondary prevention strategy for people at high risk of cardiovascular events. It is recommended that people with stable angina should have a lipid test completed every 12 months. This report also shows the percentage of your patients with stable angina who have received a lipid test between February 2010 and April 2011.

For further information see: “Management of chronic stable angina”, BPJ 39 (Oct, 2011).

Personalised feedback
Your patients with stable angina
XX%

of your patients have received a prescription for sublingual glyceryl trinitrate (spray or tablets) within the past two years, and therefore have been identified as having stable angina.

This reporting methodology will exclude those patients with well controlled angina who have not received a sublingual nitrate prescription within the reporting period, and may capture a number of patients with unstable angina who are also taking sublingual glyceryl trinitrate.

Some patients who have presented with chest pain, may have been prescribed sublingual glyceryl nitrate as a precautionary measure for suspected angina. Therefore your data may include some patients classified as having stable angina, who are not taking an antithrombotic, statin or antianginal medicine, as chest pain has subsequently been found to be secondary to another condition.

1 Antithrombotic medicines
XX%

of your patients with stable angina are receiving aspirin, clopidogrel or warfarin – compared to 81% for all General Practitioners throughout New Zealand.

No. patients on each medicine type:
XX Aspirin
XX Warfarin
XX Clopidogrel
2 Statins
XX%

of your patients with stable angina are receiving a statin – compared to 74% for all General Practitioners throughout New Zealand.

3 Antianginal
XX%

of your patients with stable angina are receiving a beta-blocker and/or a calcium channel blocker and/or a long-acting nitrate – compared to 82% for all General Practitioners throughout New Zealand.

No. patients on each medicine type:
XX Beta-blocker
XX Calcium channel blocker
XX Long-acting nitrate
1 + 2 + 3 Recommended combined treatment
XX%

of your patients with stable angina are receiving a antithrombotic, statin and beta-blocker and/or a calcium channel blocker and/or a long-acting nitrate – compared to 58% for all General Practitioners throughout New Zealand.

Lipid management
XX%

of your patients with stable angina have received a lipid test between February 2010 and April 2011 – compared to 63% for all General Practitioners throughout New Zealand.

For correspondence on this subject, see "Correspondence: Lipid testing in people with stable angina", BPJ 41 (December, 2011).

Notes:

  • Time period: May 2010 to April 2011
  • Exceptions: This reporting methodology will exclude those patients with well controlled angina who have not received a sublingual nitrate prescription within the reporting period, and may capture a number of patients with unstable angina who are also taking sublingual glyceryl trinitrate.

    Some patients who have presented with chest pain, may have been prescribed a sublingual glyceryl nitrate as a precautionary measure for suspected angina. Therefore your data may include some patients classified as having stable angina, who are not taking an antithrombotic, statin or antianginal medicine, as chest pain has subsequently been found to be secondary to another condition.

    Data on prescribing rates for dabigatran were not available at the time this report was compiled.

  • Data is assigned to you based on the recorded NZMC number for prescriptions written for CVD medications. Data has been excluded where the NZMC number or the encrypted NHI was not recorded. You may not have written the prescription for Nitrates.
  • Patient were included where they had been dispensed a sublingual nitrate (spray or tablets) in the period May 2009 to April 2011.
  • Patients that have died have been excluded.