Al-Naeem Diabetes Clinic, Primary Health Care, Jahra, Kuwait.
Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait.
Prim Care Diabetes. 2019 Jun;13(3):259-265. doi: 10.1016/j.pcd.2018.11.003. Epub 2018 Dec 19.
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.
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.
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.
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.
评估临床审核和重点干预措施对降低科威特初级保健诊所 2 型糖尿病患者心血管疾病风险的影响，方法：使用 LDL 作为心血管风险的替代指标，审核团队对他汀类药物处方的护理过程指标进行了临床审核。基本审核回顾了 100 名患者的病历，以评估患者的血脂谱和他汀类药物处方。根据国家临床实践指南制定了血脂管理方案和算法，并分发给所有医疗保健专业人员，实施了 3 个月，然后对另外 100 份记录进行了重新审核。使用 SPSS 版本 22 进行描述性和比较性统计（前后）。结果：他汀类药物的处方从基本审核中的（26%）显著增加到干预后审核中的（85%）（p<0.001）。LDL-C 值从 3.37±0.67mmol/L 显著降低到 2.71±0.79mmol/L（p<0.001）。总胆固醇均值从 5.15±0.73mmol/L 显著降低到 4.68±0.88mmol/L（p<0.001）。10 年 CHD 风险从 18.46±11.1%降低到 16.8±12.23%（p=0.152）。结论：在科威特初级保健部门，实施临床审核并结合重点干预措施，成功改善了 2 型糖尿病患者 LDL-C 的管理。
