Criteria used in the clinical audit
| Frequency met* | 95% CI | Sample† | |
|---|---|---|---|
| *Frequency with which care was provided and recorded for patients for whom the necessary care was clinically indicated; ^number of patients to whom the criterion applied. Conditional variables are shown in italics. | |||
| Note: these criteria were devised by expert panels using a systematic process to combine evidence with expert opinion.24 | |||
| Angina (n=1048) | |||
| Past 14 months, record of: | |||
| Blood pressure | 85.1% | 82.9 to 87.3 | 1048 |
| Prescribed or advised to take aspirin unless record of contraindication or intolerance | 74.0% | 71.3 to 76.6 | 1048 |
| Prescribed β blocker as maintenance therapy if sole therapy | 51.8% | 45.6 to 57.9 | 255 |
| Frequency or pattern of angina attacks | 41.5% | 38.5 to 44.5 | 1048 |
| Action taken on blood pressure if systolic blood pressure >160, or >140 if cholesterol level >5.5 mmol/l | 37.1% | 29.4 to 45.6 | 139 |
| Exercise capacity | 36.3% | 33.4 to 39.1 | 1048 |
| Past 5 years, record of: | |||
| Smoking status | 82.3% | 80.0 to 84.7 | 1048 |
| Smoking advice to smokers | 72.3% | 65.8 to 78.9 | 181 |
| Cholesterol | 62.3% | 59.4 to 65.2 | 1048 |
| Weight advice if overweight | 59.3% | 54.6 to 64.0 | 425 |
| Dietary advice | 56.9% | 53.9 to 59.9 | 1048 |
| Action taken if cholesterol >5.5 mmol/l | 55.2% | 47.3 to 62.6 | 162 |
| Ever recorded: | |||
| Referred for specialist assessment | 76.5% | 73.9 to 79.1 | 1048 |
| Referred for an exercise ECG | 41.7% | 38.7 to 44.7 | 1048 |
| Asthma (n=1133) | |||
| Past 14 months, record of: | |||
| Record of daily, nocturnal or activity limiting symptoms | 40.8% | 37.9 to 43.7 | 1133 |
| Past 5 years, record of: | |||
| Speech rate, pulse rate or respiratory rate during a consultation for an exacerbation of asthma if immediate bronchodilator therapy was used | 100% | 23.2 to 53.8 | 39 |
| Oral steroids prescribed if peak flow <60% of normal/predicted | 84.1% | 75.8 to 93.4 | 65 |
| Smoking status | 80.0% | 77.5 to 82.2 | 1133 |
| Normal or predicted peak flow or record of difficulty using a peak flow meter | 74.7% | 72.2 to 77.2 | 1133 |
| Peak flow during a consultation for an exacerbation of asthma | 69.2% | 64.5 to 73.8 | 376 |
| Action taken if patient experiencing nocturnal symptoms | 64.8% | 59.1 to 70.4 | 278 |
| Smoking advice to smokers | 58.4% | 52.8 to 64.9 | 253 |
| Referral to a respiratory physician where oral steroids are used in maintenance treatment | 53.8% | 34.7 to 73.0 | 26 |
| Action taken if patient experiencing activity limiting symptoms | 50.6% | 42.4 to 58.3 | 153 |
| Inhaler technique | 50.1% | 47.2 to 53.1 | 1133 |
| For patients with recorded exercise induced bronchospasm, short acting bronchodilators prescribed for use before exercise | 39.2% | 32.3 to 46.0 | 194 |
| Self-management plan for those on high dose steroids or who have had inpatient treatment for asthma | 37.3% | 30.9 to 43.7 | 217 |
| Type 2 diabetes (n=1111) | |||
| Past 14 months, record of: | |||
| Blood pressure | 92.9% | 91.4 to 94.4 | 1111 |
| HbA1c | 87.1% | 85.3 to 89.2 | 1111 |
| Weight | 82.2% | 79.9 to 84.5 | 1111 |
| Serum creatinine | 78.8% | 76.2 to 81.1 | 1111 |
| Examination of fundi or visual acuity | 71.9% | 69.3 to 74.6 | 1111 |
| Urine proteinuria | 69.2% | 66.4 to 71.9 | 1111 |
| Recording of peripheral pulses or record of vibration sense | 64.6% | 61.6 to 67.2 | 1111 |
| Visual examination of the feet | 62.6% | 59.7 to 65.3 | 1111 |
| Record of hypoglycaemia symptoms if patient on sulphonylurea | 21.9% | 19.0 to 24.7 | 818 |
| Past 5 years, record of: | |||
| Smoking status | 86.5% | 84.4 to 88.4 | 1111 |
| Documentation of education about diabetes if diagnosed <5 years | 82.9% | 77.6 to 85.6 | 364 |
| Serum cholesterol | 75.3% | 72.8 to 77.8 | 1111 |
| Advice given to smokers | 62.8% | 56.2 to 70.4 | 177 |
| Blood pressure: (criteria developed before publication of UKPDS trial38) | |||
| Under 80 years: Offered treatment if average of last 3 readings shows diastolic >100 or systolic >150 and diastolic >90 | 64.6% | 55.2 to 74.1 | 99 |
| Treatment (criteria developed before publication of UKPDS trial38) | |||
| Referral to a specialist where serum creatinine is >200 mmol/l | 81.2% | 62.1 to 100 | 16 |
| For patients under 70, where the last HbA 1c was >9, patient offered a therapeutic intervention aimed at improving glycaemic control | 75.9% | 68.9 to 83.3 | 134 |
| For patients over 70, where the last HbA 1c was >10, patient offered a therapeutic intervention aimed at improving glycaemic control | 64.3% | 58.8 to 89.6 | 31 |
| If patient is being treated for hypertension and has proteinuria (macro- but not micro-albuminuria), the patient is on an ACE inhibitor | 50.4% | 46.2 to 54.6 | 530 |
| If patient was started on ACE inhibitor, creatinine and potassium were measured within 1 month of starting treatment | 37.5% | 31.7 to 43.3 | 272 |