1. Management of Patients following a Myocardial Infarction in the Community Dr Anjali Kay GPST3, Dr Katharine Saxby GP Partner 6-8th October 2016
Introduction
The audit was selected to improve management following Myocardial infarction. A questionnaire was composed from the NICE guidelines, the GP contract, the OHS Long term conditions long term guidelines and Local Commissioned Service for long term conditions LTC LCS.
17 audit standards were set and results recorded in graph form. This was a retrospective audit of all patients who had had an MI in the last 5 years (total 35 patients).
The audit demonstrated that patients were on the register, on correct drugs (ACEi, Statin, antiplatelet and Beta blocker) and received a cholesterol check. Patients however were not all offered a flu vaccine, advised about smoking cessation, given lifestyle counselling, managed for BP, their bloods checked annually or had an individualised management plan. There were insufficient medication reviews and attendance at nurse led annual review was low. There was a mixture of information in the discharge summaries.
Conclusion
The audit was discussed at a clinical meeting. We agreed continuing to opportunistically give flu vaccine, provide smoking cessation advice and manage BP. We also noted the need to improve attendance at the annual review where these things could also be done. Improving attendance would be by reminders on the notes, limiting medication after 3 recalls. The individualised plan would empower patients. A practice protocol for 1, 3 and 12months post MI has been generated and to capture information about up titrating drug dosages in particular. There will be a re-audit.
References: Health data for the joint strategic needs Assessment Ordsall and Langworthy, Neighbourhood Profile Dec 2010 update
NICE guidelines [CG172] Myocardial Infarction: Cardiac Rehabilitation and prevention of further MI. [Internet] Nov 2013 [cited 2015 Nov 25] Available from: