Abstract: . . .  Cholesterol/lipid levels Table 5 Outcome or Proxy Outcome Standards for Angina 9.27 All newly diagnosed patients from 1 st April 2001, must have the minimum data set recorded in their notes, set out in Table 3. 9.28 The practice must have a written policy for its management of patients with angina . 9.29 The standards used for post MI management for the following elements will also apply to patients with angina : blood pressure, cholesterol lowering, use of aspirin or anticoagulant, smoking. a) All patients should have had their haemoglobin checked as part of their initial investigations. b) All patients should have had their plasma glucose measured to exclude diabetes as part of the initial investigations. c) All patients with stable angina should have had an exercise test, (or thallium scan). d) All patients with stable angina who require treatment, such as calcium antagonists, potassium channel blockers, nitrates, should be treated with a beta blocker unless contra indicated. e) All newly diagnosed patients with possible angina , under the age of ???, should be referred to a specialist clinic, according to locally agreed protocols. 9.30 From April 1 st 2001, to be monitored 31 st march 2002, the following standards: 1 a) Statin therapy should aim to lower total cholesterol below 5 mmol/l or to reduce total serum cholesterol by 20-25%, whichever would result in the lowest level of cholesterol. b) If the total pre-treatment cholesterol is > 6.21 mmol/l it must be reduced to below 5mmol/l. c) If the total pre-treatment cholesterol is < 6.2 mmol/l it must he reduced by at least 20% (whatever the pre-treatment level is). d) If no pre-treatment level is available the total cholesterol should be below 5 mmol. No initial total cholesterol should be listed as an exception. e) If the pre-treatment level is = 4 mmol/l then there is no requirement to reduce the cholesterol any lower. 2001-2002 50% 2002-2003 70% 2003-2004 90% Page 6 East Kent Health Authority Clinical Effectiveness Primary Care (PRICCE) Guidelines 43 15 April 2003 Cholesterol lowering targets to come into effect for all PRICCE Practices and PEP practices from April 1 st 2001 Table 6 9.31 The practice will record the smoking status for all patients with angina and post MI. The practice should also record delivery of and/or referral for smoking cessation advice for all smokers. These standards will come into effect from April 1 st 2001 for all practices. To be monitored . . .
--3000,1,1500,3091,15950