Management of Low Density Lipoprotein Cholesterol at a primary care diabetes clinic in Kuwait
Affiliations
Affiliations
- Al-Naeem Diabetes Clinic, Primary Health Care, Jahra, Kuwait. Electronic address: Alfred.nassif@outlook.com.
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait.
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK.
- University of Dundee Ninewells Hospital, Dundee, Scotland, UK.
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.
Keywords: Audit; Clinical guidelines; Diabetes; Kuwait; Low Density Lipoprotein Cholesterol.
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