Authors (including presenting author) :
Dr. LIU YM, Dr LAU CH, Dr. CHEN XR Catherine, Dr. LI YC
Affiliation :
Dept. of Family Medicine and General Outpatient Clinics (GOPCs), Kowloon Central Cluster, Hospital Authority.
Introduction :
Ischemic heart disease (IHD) is an important disease both in Hong Kong (HK) and worldwide. Its incidence is of increasing trend and it is associated with significant morbidity and mortality. There is strong evidence supporting that proper control of cardiovascular risk factors and appropriate use of pharmacological treatment would improve patient outcomes and prevent recurrent heart attack.
Objectives :
To audit secondary preventive care in patients with IHD managed in a public primary care clinic in HK.
Methodology :
All stable IHD patients who had been regularly followed-up at Robert Black GOPC during the audit cycle were recruited. Evidence-based audit criteria and performance standards were set after reviewing data from local and overseas audit studies and latest international guidelines. Phase 1 evaluation was performed from 1st Jun 2017 to 31st Dec 2017, areas of deficiency were identified. Active interventions were implemented for 12 months and Phase 2 evaluation was carried out from 1st Dec 2018 to 30th June 2019. Chi-square test and Student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2.
Result & Outcome :
Phase 1 data showed pronounced deficiencies in the assessment and control of cardiovascular disease (CVD) risk factors. For CVD risk factors control, only 34% and 18.4% of patients can achieve the optimal blood pressure (BP) control target and lipid control target respectively. The glycemic control rate was 49.3% among patients with diabetes mellitus (DM). Following active intervention, marked improvements in outcomes were observed. Phase 2 data showed that optimal BP control rate and lipid control rate were achieved in 58.5% and 58.4% of targeted patients respectively (P< 0.001), while the optimal glycemic control rate was improved to 70.5% (P=0.008).
