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Recipe Name:

Identifying Home Medication Review candidates: Heart Failure patients who are not on ACE inhibitors

Rationale:

ACE inhibitors reduce mortality and morbidity at any grade of systolic heart failure (NPS News 57), even in patients with asymptomatic disease. A search of electronic records can help identify high-risk patients who may benefit from a medication review. This initiative will assist GPs in improving the quality of their prescribing for heart failure.

Target:

To identify patients who would benefit from a Home Medication Review (DMMR).

CAT Starting Point:

  1. CAT Open - CAT4 view (all reports) loaded
  2. Population Extract Loaded and Extract Pane “Hidden”
    1. Filter Pane open and under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected (this step can be
       omitted if you want to search for all patients).
     



Filter Steps

  • Under the 'Conditions' tab, choose the 'Chronic' tab, and then select 'Heart Failure' under the Cardiovascular section



  • Under the 'Medications - Heart' tab, in the“ACE or ARB” category, tick “No”.



  • Click 'Recalculate to apply the filter


Recipe Steps Reports

  • Hide Filters
  • Select the "Medications" tab
  • Select the "Medications per Patient" tab
  • Click the "with 8+ meds" slice of the graph
  • Click on Export to show the list of patients



This list will display those patients diagnosed with Heart Failure who are not on ACE inhibitors, but are on more than 8 other medications.


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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