Lipids, Familial Hypercholesterolaemia (FH), PCSK9i & Inclisiran Report Guide for SystmOne

A suite of Reports for SystmOne, created by the CDRC can be used identify patients in your practice who might benefit from lipid lowering or optimisation of treatment.

These reports have been categorised into 3 primary areas:

Quality Improvement – Reports to identify patients who might benefit from lipid lowering or treatment optimisation.
Performance – Reports to show current performance with respect to lipid management.
Statin Safety – Reports to identify patients with significant statin safety issues.

Before starting your Lipid Management, CDRC recommends that you first run the reports in the ‘Casefinding Reports’ node to identify patients with potentially un-coded conditions that will affect decisions about lipid modification.

Casefinding Reports

We recommended that you first run the reports in each of the nodes below to identify patients with potentially un-coded conditions that will affect decisions about lipid modification.

Atrial Fibrillation

Report Name	Report Location	Report Returns	Notes
? AF 2.1 Casefinding – Medication that might be for AF but no AF code	CDRC Quality > Cardiovascular	Patients with chronotropic medication without any obvious reason*	Also likely to lead to detection of uncoded CHD, heart failure, hypertension, Raynauds, SVT, VT
? AF 2.2 Casefinding – AF potential indicator but no AF code	CDRC Quality > Cardiovascular	Patients with codes which might indicate AF such as ‘AF annual review’ or ‘CHADS score’	Check for uncoded AF and/or consider removing any erroneous historic codes.
? AF 2.3 Casefinding – Irregular pulse but no subsequent ECG	CDRC Quality > Cardiovascular	Patients with a record of an irregular pulse without a subsequent ECG to check for AF	Consider offering repeat pulse check and/or ECG
? AF 2.4 Casefinding – AF marked as resolved	CDRC Quality > Cardiovascular	Patients who have been removed from the AF register by virtue of AF resolved	Recent information suggests that patients with AF should not be removed from AF registers prematurely as they remain at higher risk of stroke.

*reports for individual drugs can be found in the same folder called ? Drug to diagnosis 00x – xxxxx without obvious indication

Coronary Heart Disease

Report Name	Report Location	Report Returns	Notes
? CHD 2.1 Casefinding – Potential CHD Indicator but no QoF code	CDRC Quality – Cardiovascular	Patients with codes which might indicate CHD such as ‘CHD annual review’ or ‘angina control’	Check for uncoded CHD and/or consider removing any erroneous historic codes.
? CHD 2.2 Casefinding – Potential MI Indicator but no QoF code	CDRC Quality – Cardiovascular	Patients with codes which might indicate CHD such as ‘H/o myocardial infarction’	Check for uncoded CHD and/or consider removing any erroneous historic codes.
? CHD 2.3 Casefinding – Medication that might be for CHD but no CHD code #	CDRC Quality – Cardiovascular	Patients taking medication indicated for CHD without any obvious reason*	Also likely to detect AF, heart failure, hypertension, PAD, Raynauds, stroke/TIA, SVT, VT

*reports for individual drugs can be found in the same folder called ? Drug to diagnosis 00x – xxxxx without obvious indication

The following report may also identify patients with CHD as well as other atherosclerotic disease:

CDRC Quality > Cardiovascular> ? Drug to Diagnosis 003 – Antiplatelets without obvious indication

Heart Failure

Report Name	Report Location	Report Returns	Notes
? Heart Failure 2.1 – Case Finding – Significantly raised BNP w/o HF	CDRC Quality – Cardiovascular	Patients with a significantly raised BNP without diagnosis of heart failure	Review record
? Heart Failure 2.2 – Case Finding – LVSD/LVDD or moderately raised BNP – on loop diuretic	CDRC Quality – Cardiovascular	Patients taking loop diuretics with LV systolic or diastolic dysfunction or a raised BNP	Review record
? Heart Failure 2.3 – Case Finding – Heart failure medication but no heart failure diagnosis	CDRC Quality – Cardiovascular	Patients taking spironolactone/eplerenone/sacubitril without obvious reason. (will detect some patients being given spironolactone for resistant hypertension)

*reports for individual drugs can be found in the same folder called ? Drug to diagnosis 00x – xxxxx without obvious indication

Additional patients might be found in the drug to diagnosis audits for beta-blockers and renin-angiotensin drugs

Hypertension

Report Name	Report Location	Report Returns	Notes
? Hypertension 2.1 Casefinding – Potential Hypertension indicator but no HT code	CDRC Quality – Cardiovascular	Patients with codes which might indicate hypertension such as ‘hypertension annual review’	Check for uncoded hypertension and/or consider removing any erroneous historic codes.
? Hypertension 2.2 Casefinding – Medication that might be for HT but no HT	CDRC Quality – Cardiovascular	Patients taking medication indicated for hypertension without any obvious reason*	Also likely to detect AF, CHD, heart failure, PAD, Raynauds, SVT, VT
? Hypertension 2.3 Casefinding – ABPM>135/85 and not appropriately coded	CDRC Quality – Cardiovascular	Patients with a home BP <=135/85 without a diagnosis of hypertension.	Review record and add hypertension code or correct home BP if this was incorrect.

*reports for individual drugs can be found in the same folder called ? Drug to diagnosis 00x – xxxxx without obvious indication

CKD Diagnosis

Report Name	Report Location	Report Returns	Notes
? CKD 2.1 Casefinding – Suspected CKD3-5 but not coded	CDRC Quality – Renal	Patients with last two eGFR readings <60 at least 3 months apart but no code for CKD3-5	Consider adding CKD code
? CKD 2.2 Casefinding – eGFR<60 over 4 months ago but not coded with CKD 3-5	CDRC Quality – Renal	Patients whose last eGFR was <60 (at least 4 months ago) without a code for CKD 3-5	Review record. Consider repeat eGFR
? CKD 2.21 Casefinding – eGFR<50 over 4 months ago but not coded with CKD 3-5	CDRC Quality – Renal	As above but eGFR <50 so more specific but less sensitive	Review record. Consider repeat eGFR
? CKD 2.3 Casefinding – Repeated ACR>3 but not coded with CKD #	CDRC Quality – Renal	Patient with last two ACR readings >3 without a diagnosis of CKD1-5	Consider adding CKD code
? CKD 2.31 Casefinding – Repeated ACR>3 but not coded with CKD #	CDRC Quality – Renal	As above but excluding people on the diabetes renal disease QoF register	Consider adding CKD code

Stroke / TIA Casefinding

Report Name	Report Location	Report Returns	Notes
? Stroke TIA 2.1 Casefinding – Potential Stroke Indicator but no QoF Code	CDRC Quality – Neurology	Patients with codes which might indicate stroke/TIA such as ‘stroke annual review’ or ‘amaurosis fugax’ There are two separate reports that subdivide admin and clinical codes	Check for uncoded stroke/TIA and/or consider removing any erroneous historic codes.
? Stroke TIA 2.2 Casefinding – Vascular dementia codes without H/O stroke/TIA	CDRC Quality – Neurology	Many patients with vascular dementia have had cerebral infarcts	Review hospital letters and scan results to look for evidence of past cerebral infarction
? Stroke TIA 2.3 Casefinding – Unclassified stroke type #	CDRC Quality – Neurology	Patients with code for stroke which isn’t further classified as a haemorrhagic or ischaemic stroke	Review hospital letters and scan results to look for evidence of stroke type. Replace generic stroke code with specific code
? Stroke TIA 2.31 Casefinding – Non-classified stroke on antiplatelets or anticoagulant	CDRC Quality – Neurology	Patient as in 2.3 but already taking antiplatelets or anticoagulants so more likely to have had ischaemic stroke	As above.

The report following report may also identify patients with stroke as well as other atherosclerotic disease

CDRC Quality > Cardiovascular > ? Drug to Diagnosis 003 – Antiplatelets without obvious indication

PAD Casefinding

Report Name	Report Location	Report Returns	Notes
? PAD 2.1 Casefinding – PAD drugs but no PAD diagnosis #	CDRC Quality – Neurology	Patients with medication which might indicate PAD such as naftidrofuryl	Check for uncoded PAD .
? PAD 2.2 Casefinding – PAD procedure but no QoF code	CDRC Quality – Neurology	Patients with codes which might indicate PAD such or ‘fem-pop bypass’	Check for uncoded PAD and/or consider removing any erroneous historic codes.

The following report may also identify patients with PAD as well as other atherosclerotic disease:

CDRC Quality > Cardiovascular > ? Drug to Diagnosis 003 – Antiplatelets without obvious indication

Quality Improvement Reports

CDRC’s Quality Improvement Reports will help to identify patients who may benefit from lipid lowering or treatment optimisation, they are located in the folder CDRC Quality > Lipids.

These reports have been categorised to allow for manageable numbers of patients depending on the resource you have available.

Lipid Screening – Screening for people at risk of CVD

Report Name	Report Returns
? Lipids 1.0 Screening – Target for CVD Risk Assessment (as estimated risk is >10%)	Patients whose estimated CVD risk is >10%. Excludes: On lipid lowering therapy Recorded reason why lipid lowering therapy not being taken Established CVD or FH
? Lipids 1.01 Screening – Target for CVD Risk Assessment – eligible for NHS HC	Patients in 1.0 who are currently eligible for and NHS Health Check
? Lipids 1.02 Screening – Target for CVD Risk Assessment – has LTC	Patients in 1.0 who also have a long term condition
? Lipids 1.03 Screening – Target for CVD Risk Assessment – not eligible for NHS HC, no LTC	Patients in 1.0 who do not have a long term condition and who are not currently eligible for an NHS Health Check
? Lipids 1.04 Screening – Target for CVD Risk Assessment – estimated risk >20%	Patients in 1.0 who have an estimated CVD risk >=20%

Lipid Screening – Screening for Familial Hypercholesterolaemia

Report Name	Report Returns
? Lipids 2.0 Case Finding – Consider screening for familial hypercholesterolamia	Patients who have a significant chance of familial hypercholesterolaemia
? Lipids 2.01 Case Finding – Consider screening for familial hypercholesterolamia (also eligible for IFF FH referral)	Patients in 2.0 who are also appear in the IIF CVD04 ‘consider for FH assessment’ denominator
? Lipids 2.02 Case Finding – Consider screening for familial hypercholesterolamia – highest risk patients	Patients in 2.0 who are at highest risk of FH – for areas with limited resources – concentrate on these patients
? Lipids 2.1 Case Finding – Eligible for IFF FH referral but FH less likely	Patients who appear in the IIF CVD04 ‘consider for FH assessment’ denominator, who are less likely to have FH
? Lipids 2.2 Case Finding – Code for FH but not genetic code – consider need for genetic testing	Patients with a code suggesting FH e.g. Possible FH who don’t have a definitive FH code

Click here for further resources to assist with FH Screening.

Lipid Management – Consider Starting / Restarting Lipid Lowering

Report Name	Report Returns
? Lipids 3.0 Management – Consider Lipid Lowering	Patients who appear eligible for lipid lowering for primary or secondary prevention who don’t have a recorded reason why not.

This report has sub-reports which risk stratify patients so those at highest risk can be prioritised (3.01-3.06)

Report Name	Report Returns
? Lipids 3.2 Management – Possible poor lipid lowering therapy concordance	Patients with repeat lipid lowering therapy who have not been issued a prescription in the last 3 months.

Lipid Management – Lipid Lowering Optimisation

Report Name	Report Returns
? Lipids 4.1 Management – On lipid lowering – without a lipid target	Patients with repeat lipid lowering therapy who do not have a lipid target.
? Lipids 4.2 Management – On lipid lowering – has lipid target but not achieved	Patients with a lipid target which has not been achieved.
? Lipids 4.3 Management – On low/mod lipid lowering – consider intensification	Patients on moderate or low potency lipid lowering without a documented reason. There is a subset report limited to people with manifest ASCVD only.
? Lipids 4.31 Management – On low/mod lipid lowering – consider intensification (excl. target is achieved)	As for 4.3 but excludes patients who have reached their target cholesterol There is a subset report limited to people with manifest ASCVD only.
? Lipids 4.4 Management – Consider intensification to very high intensity lipid lowering	Patients eligible for secondary prevention who are not on very high intensity lipid lowering.
? Lipids 4.41 Management – Consider intensification to very high intensity lipid lowering (excl. target is achieved)	As for 4.4 but excluding patients who have reached their target cholesterol.
? Lipids 4.5 Management – Consider intensification for patients with ASCVD and LDLC >=2.6	Patients with established atherosclerotic ASCVD with their latest LDLC was >=2.6

Lipid Management – May Need Specialist Lipid Management

Report Name	Report Returns
? Lipids 5.1 Management – Consider lipid lowering – May need more detailed input	Patients who appear to need lipid lowering but have had ADR to at least one statin AND ezetimibe
? Lipids 5.2 Management – Criteria for PCSK9i but poor concordance with current treatment	Fulfil referral criteria for PCSK9i therapy but may not be taking current lipid lowering therapy
? Lipids 5.3 Management – Criteria for PCSK9i – Consider primary care intensification	Fulfil referral criteria for PCSK9i therapy but there may be scope for intensification of lipid lowering therapy in primary care
? Lipids 5.4 Management – Criteria for PCSK9i – Consider referral **	Likely to be eligible for PCSK9i referral
? Lipids 5.5 Management – Criteria for Inclisiran – But poor concordance with current treatment	Fulfil referral criteria for inclisiran therapy but may not be taking current lipid lowering therapy
? Lipids 5.6 Management – Criteria for Inclisiran – Consider primary care intensification	Fulfil referral criteria for inclisiran therapy but there may be scope for intensification of lipid lowering therapy in primary care
? Lipids 5.7 Management – Criteria for Inclisiran – Consider treatment	Likely to be eligible for inclisiran treatment

Lipid Management – Primary Prevention

Report Name	Report Returns
? Lipids 6.1 Primary Prevention – Possible poor lipid lowering therapy concordance	Patients with repeat lipid lowering who have not been issued a prescription in the last 3 months.
? Lipids 6.2 Primary Prevention – Consider starting lipid lowering	Patients who appear eligible for lipid lowering for primary and secondary prevention who don’t have recorded reason why not.
? Lipids 6.3 Primary Prevention – Consider setting lipid target	Patients with repeat lipid lowering therapy who do not have a lipid target.
? Lipids 6.4 Primary Prevention – Lipid target set but not achieved	Patients with a lipid target which has not been achieved
? Lipids 6.5 Primary Prevention – On low/mod LLT – Consider LLT intensification	Patients on low or moderate potency lipid lowering without a documented reason.
? Lipids 6.51 Primary Prevention – On low/mod LLT – Consider LLT intensification (unless target already achieved)	As for 6.5 but excludes patients who have reached their target cholesterol
? Lipids 6.8 – Lipid check overdue	Patients who have not had a lipid test in the last 15 months

Lipid Management – Secondary Prevention

Report Name	Report Returns
? Lipids 7.0 Secondary Prevention – Has manifest atherosclerosis (ASCVD)	All patients with ASCVD.
? Lipids 7.1 Secondary Prevention – Possible poor lipid lowering therapy concordance	Patients with repeat lipid lowering who have not been issued a prescription in the last 3 months.
? Lipids 7.2 Secondary Prevention – Consider starting lipid lowering	Patients who appear eligible for lipid lowering for primary and secondary prevention who don’t have recorded reason why not.
? Lipids 7.3 Secondary Prevention – Consider setting lipid target	Patients with repeat lipid lowering therapy who do not have a lipid target.
? Lipids 7.4 Secondary Prevention – Lipid target set but not achieved	Patients with a lipid target which has not been achieved
? Lipids 7.5 Secondary Prevention – On low/mod LLT – Consider LLT intensification	Patients on low or moderate potency lipid lowering without a documented reason.
? Lipids 7.51 Secondary Prevention – On low/mod LLT – Consider LLT intensification (unless target already achieved)	As for 6.5 but excludes patients who have reached their target cholesterol
? Lipids 7.6 Secondary Prevention – Consider intensification to very high intensity lipid lowering	Patients eligible for secondary prevention who are not on very high intensity lipid lowering.
? Lipids 7.61 Secondary Prevention – Consider intensification to very high intensity lipid lowering (unless target already achieved)	As for 7.6 but excluding patients who have reached their target cholesterol.
? Lipids 7.7 Secondary Prevention – Consider intensification (NICE) – ASCVD without nonHDLC <=2.6 OR LDLC <=2.0	Patients with ASCVD with their latest nonHDL C not <=2.6 or latest LDLC <=2.0.
? Lipids 7.71 Secondary Prevention – Consider intensification (NICE) – ASCVD without nonHDLC <=2.6 OR LDLC <=2.0 (personal target not set OR set but not achieved)	As for 7.7 but excluding patients who have a lipid target and have achieved this target.
? Lipids 7.72 Secondary Prevention – Consider intensification (NICE) – ASCVD without nonHDLC <=2.6 OR LDLC <=2.0 (personal target set and achieved)	As for 7.7 but including patients who have a lipid target and have achieved this target.
? Lipids 7.9 Secondary Prevention – Lipid check overdue	ASCVD patients without a cholesterol test in the last 15 months.

Performance Reports

The following reports in the CDRC Performance > Lipids folder will provide a picture of your practice’s lipid management performance.

Overview

Report Name	Report Returns
1 Lipids – Overview 1.0 – Proportion of population on Lipid Rx	Number of people with lipid lowering therapy on repeat prescription
1 Lipids – Overview 1.1 On Lipid Rx with issue in last 3m	Number of people with lipid lowering therapy on repeat prescription who have had a prescription in the last 3 months
1 Lipids – Overview 1.2 On Lipid Rx with lipid target	Number of people with lipid lowering therapy on repeat prescription who have a recorded lipid target
1 Lipids – Overview 1.21 On Lipid Rx with lipid target and target achieved	Number of people with lipid lowering therapy on repeat prescription who have achieved their lipid target
1 Lipids – Overview 2.0 Has indication for lipid lowering	All patients who appear to have a good indication for lipid lowering (primary and secondary prevention)
1 Lipids – Overview 2.1 Has indication for lipid lowering on lipid lowering	The number of patients in 2.0 who have lipid lowering medication on repeat
1 Lipids – Overview 2.11 Has indication for lipid lowering on lipid lowering (high/very high intensity)	The number of patients in 2.0 who have high/very high intensity lipid lowering medication on repeat
1 Lipids – Overview 2.2 – Proportion where Lipid Rx indicated but not treated nor reason recorded	Number of people who appear eligible for lipid lowering who do not have: Lipid lowering on repeat A clear reason for not using lipid lowering
1 Lipids – Overview 3.0 – Proportion of patients to target for CVD risk assessment	Number of patients with an estimated CVD risk >=10% who should be offered a formal CVD risk assessment

Secondary Prevention

Report Name	Report Returns
2 Lipids – ASCVD 1.0 Has manifest atherosclerosis (ASCVD)	Patients with AAA, CHD, PAD, ischaemic/unclassified stroke or TIA
2 Lipids – ASCVD 1.1 Very high intensity lipid lowering	Established ASCVD and on very high intensity lipid lowering
2 Lipids – ASCVD 1.2 On high/very high intensity lipid lowering	Established ASCVD and on high or very high intensity lipid lowering
2 Lipids – ASCVD 1.3 On high/very high intensity Rx OR On low/mod intensity Rx with reason #	Established ASCVD: on high or very high intensity lipid lowering OR On low or moderate intensity lipid lowering with maximal tolerated lipid lowering recorded in the last year OR Atorvastatin ADR recorded
2 Lipids – ASCVD 1.4 On lipid lowering	Established ASCVD on any lipid lowering
2 Lipids – ASCVD 1.41 On lipid lowering – issued in the last 3 months	Established ASCVD on any lipid lowering AND issued in the last 3 months
2 Lipids – ASCVD 1.42 On lipid lowering – with cholesterol target	Established ASCVD on lipid lowering therapy with a record of a lipid target (usually non-HDL cholesterol)
2 Lipids – ASCVD 1.421 On lipid lowering – with cholesterol target – target achieved	As 1.42 with target achieved
2 Lipids – ASCVD 1.5 On lipid lowering OR Reason why not	Established ASCVD on any lipid lowering or clear reason why not – should be aiming for 100%

Familial Hypercholesterolemia

Report Name	Report Returns
3 Lipids – FH 1.0 Definite or probable	Definite or probable familial hypercholesterolaemia
FH reports 1.1 – 1.5 as for the ASCVD reports above

Primary Prevention

Report Name	Report Returns
4 – Lipids – PP 1.0 Primary Prevention Indicated	Primary prevention by lipid modification is likely to be recommended for these patients
PP report 1.1 – 1.6 as for the ASCVD report above

CVD Risk Assessment

Report Name	Report Returns
5 Lipids – Assess CVD Risk 1 – estimated risk >=10%	Patients whose estimated 10 year risk of CVD is >=10% who have not had a formal risk assessment.
5 Lipids – Assess CVD Risk 2 – Already on lipid lowering without risk assessment	Patients on lipid lowering without an obvious indication.

Statin Safety Reports

The following reports will identify important statin safety issues. Use the Lipid Lowering template to help.

The following reports are found in the CDRC Quality > Lipids folder:

Report Name	Report Returns	Notes
? Statin Safety 1.0 – Any statin – potential contraindicated interaction #	Patients on repeat statin and another medication that appears to be contraindicated	Review patient medication to ensure safety
? Statin Safety 1.1 – Simvastatin – ! MHRA ! Any potential contraindicated interaction #	(Subset of 1.0 above) Patients on simvastatin with a contraindicated medication in line with the MHRA warning	Review record https://www.gov.uk/drug-safety-update/simvastatin-updated-advice-on-drug-interactions
? Statin Safety 2.0 – Any statin – caution, potential interaction #	Patients on repeat statin and another medication where caution is recommended	Review patient medication to ensure safety
? Statin Safety 3.0 – Any statin – consider dose in view of eGFR #	Patients on repeat statin whose renal function indicates that dose alteration MAY be needed	Review patient medication to ensure safety

Recommended Batch Reporting

Consider running the follow reports in automatic batches so the relevant professional or group are notified about patients to review at appropriate interval. For more details on setting this up see Automated Reporting

Monthly Batch

Report Name	Report Location	Report Return	Notes
? Lipids 3.2 Management – Possible poor lipid lowering therapy concordance #	CDRC Quality > Lipids	Patients who don’t seem to be taking their prescribed lipid lowering	Contact patient to review concordance
Lipids > ? Statin Safety 1.0 – Any statin – potential contraindicated interaction #	CDRC Quality > Lipids	Patients with potential serious statin interactions.	Use Lipid Lowering Template to review potential serious interactions

Quarterly Batch

Report Name	Report Location	Report Returns	Notes
? Statin Safety 3.0 – Any statin – consider dose in view of eGFR	CDRC Quality > Lipids	Patients who may need dose adjustments based on renal function	Review record. Consider suitability of statin dose given eGFR
? Lipids 4.6 Consider remote statin intensification	CDRC Quality > Lipids	Patients who could have an electronic invite to consider statin intensification
? Lipids 1.04 Screening – Target for CVD Risk Assessment – estimated risk >20%	CDRC Quality > Lipids	Patients at highest risk of CVD who have not had a CVD risk assessment	Consider inviting for a CVD risk assessment.

Annual Batch

Report Name	Report Location	Report Returns	Notes
? Lipids 2.0 Case Finding – Consider screening for familial hypercholesterolaemia #	CDRC Quality > Lipids	Patients who may have familial hypercholesterolaemia	Review record and refer if appropriate
? Lipids 4.3 Management – On low/mod lipid lowering – consider intensification #	CDRC Quality > Lipids	Patients to consider for lipid lowering intensification	Review patient and consider intensification or recording maximally tolerated treatment
? Lipids 4.4 Management – Consider intensification to very high intensity lipid lowering #	CDRC Quality > Lipids	Patients to consider for lipid lowering intensification (secondary prevention only)	Review patient and consider intensification or recording maximally tolerated treatment
? Lipids 5.1 Management – Consider lipid lowering – May need more detailed input	CDRC Quality > Lipids	Patients with more complex lipid issues e.g. previous intolerance to statin AND ezetimibe	Review record and consider treatment/referral
? Lipids 5.4 Management – Referral Criteria for PCSK9i – Consider referral	CDRC Quality > Lipids	Patients who might benefit from PCSK9i treatment	Consider offering a referral to local lipid clinic
Diabetes DM022 \| Potential Fix – Consider adding SNOMED code for statin ADR	CDRC Contracting > QoF	Diabetic patients who are missing from the diabetes over 40 statin QoF indicator – with a record of an S1 adverse reaction to statin but no SNOMED code	Consider adding SNOMED code – no clinical benefit but helps with performance measures.
Diabetes DM023 \| Potential Fix – Consider adding SNOMED code for statin ADR	CDRC Contracting > QoF	Diabetic patients who are missing from the diabetes and CVD statin QoF indicator – with a record of an S1 adverse reaction to statin but no SNOMED code	Consider adding SNOMED code – no clinical benefit but helps with performance measures.

Batch Contacting Patients to Consider Lipid Lowering Intensification

The following process allows quick and effective contact with patients to consider intensification of lipid lowering therapy.

Use these reports to identify people who might eligible for the process. Criteria are:
- Not manifest atherosclerosis
- Not previous tried high intensity statin
- Not clear reason to avoid high intensity statin
- Not declined intensification in the last year

Use the communications annexe to send selected patients the following message and questionnaire. Add the code Offer of statin therapy to invited patients. Patients without a mobile number or email address will need to be contacted in a different way e.g. phone or letter.

This is the text to cut and paste into the message – a preset can be created for future use.

We’ve reviewed your record and you may benefit from better treatment of your cholesterol. Use the link below for more information.

<staff_member_title> <staff_member_forename> <staff_member_surname>

The patient will receive the following questionnaire. Replies will appear as a task in SystmOne

Patients who answer ‘yes’ can be contacted. To discuss intensification. The two sub-reports 4.61 and 4.62 divide patients into those who are likely to be relatively simple (only been on one statin previously) or more complicated (multiple previous statins or previous high intensity statins).

Patients who answer ‘no’ should have the code Patient on maximal tolerated lipid lowering therapy added.

Atrial Fibrillation

Coronary Heart Disease

Heart Failure

Hypertension

CKD Diagnosis

Stroke / TIA Casefinding

Lipid Screening – Screening for people at risk of CVD

Lipid Screening – Screening for Familial Hypercholesterolaemia

Lipid Management – Consider Starting / Restarting Lipid Lowering

Lipid Management – Lipid Lowering Optimisation

Lipid Management – May Need Specialist Lipid Management

Lipid Management – Primary Prevention

Lipid Management – Secondary Prevention

Overview

Secondary Prevention

Familial Hypercholesterolemia

Primary Prevention

CVD Risk Assessment

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