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Recipe Name:

Identify patients with a stroke or TIA not on cholesterol lowering medication

Rationale:

Cholesterol lowering therapies (unless contraindicated) are recommended for all ischaemic stroke patients regardless of cholesterol level. Reducing mean LDL cholesterol levels from 133 mg/dl to 73 mg/dl (1.9 mmol/L) among patients receiving atorvastatin (80mg) resulted in absolute risk reduction of 2.2% over five years for fatal or non fatal stroke and 3.5% for major cardiovascular events1.

Target:

Effectively identify all ischaemic stroke / TIA patients not on   cholesterol lowering medications (unless contraindicated) that  would benefit from therapy with a statin. Refer patients for lifestyle advice.

CAT Starting Point:

  1. CAT Open
  2. Population Extract Loaded and Extract Pane "Hidden"
  3. OPTIONAL ONLY{*}: Filter Pane Open and, under the General Tab, "Active Patients (3x < 2 years)" selected

*The decision to select either "Active" or "All" patients is left to the practice to make




In the Filters Pane:

1. In the "Conditions" tab select "Stroke" Yes 



2. In the "Medications" tab under "Medications – Heart" select

  1.  Lipid M/fying - No



2. Click "Recalculate"  



3. Click "View Pop"



This will list all active (if selected on the general filter tab) patients who had a stroke currently not taking lipid modifiying medication and their last visit and assigned provider.

 
  

To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”


The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up



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This CAT Recipe was submitted by

National Stroke Foundation
and supports their Clinical Guidelines for Stroke
and TIA Management: A guide for general practice, 2008.
 http://www.strokefoundation.com.au/health-professionals