Background:

Dandenong Chronic Disease Management (CDM) clinic is a tertiary outpatient multidisciplinary clinic providing evidence based management of patients with diabetes and complex health needs. Patients who have established cardiovascular disease (CVD) or at high risk of developing CVD are a target group.  Management is aimed at reducing risk factors, including dyslipdaemia, which is a common comorbidity.

 Lipid-lowering therapy reduces the risk of CVD in patients who have previously had a cardiovascular event or who are at high risk. National evidence based guidelines¹ recommend those, who have established CVD or high absolute risk receive lipid-modifying therapy. 

Aim: 

To assess the lipid management of patients attending CDM clinic to determine if national guideline standards are being met. 

Objectives:

To determine the proportion of patients in CDM clinic who have high cardiovascular risk.

To determine the percentage of patients with high cardiovascular risk who are prescribed lipid-lowering agents.

To study the prescribing behaviour of lipid lowering agents.

To determine if national lipid targets are being met.

Methods:

A retrospective chart audit was performed. All patients who attended the Dandenong Diabetes CDM clinic from January 1 2014 to June 30 2014 medical records were reviewed.

Results:

A total of 119 patient records were reviewed.  57% of patients attending the clinic had a high cardiovascular risk.  Of those who had high cardiovascular risk, 77% of patients were prescribed lipid-lowering agents.  Most patients were prescribed HMG-CoA reductase treatment with Atorvastatin being the most popular.  49% of patients who were deemed high risk were meeting LDL targets.  Much less met the triglyceride and HDL recommended levels.  The majority of patients who were achieving recommended target levels were treated with lipid-lowering agents. 

Conclusion:

A large proportion of patients who are at high risk are being treated with lipid- lowering treatment, however many patients were not reaching the recommended target levels.  Appropriately many of the patients were prescribed HMG-CoA reductase treatment which is recommended as first line.  One limitation to this study was the inability to determine if any patients had a contraindication to lipid-lowering therapy.