Audits - Cardiovascular

Please select from the following Audits.

Aspirin Discontinuation Audit

This audit reviews the appropriate use of aspirin as per national guidelines

Aspirin Discontinuation AuditDownload File
(Aspirin_discontinuation_audit_updated_Aug_2015.pdf)

Date Uploaded: 26/08/2015

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Calcium Channel Blockers

This audit aims to ensure that the budget invested in the NHS D&G Joint Formulary calcium channel blockers (CCBs) for the management of hypertension and angina is cost effective and rational. Amlodipine is the most cost effective CCB in its class and the review will facilitate identification of patients for whom this would be an appropriate CCB. Formulary compliance will also be reviewed with this audit.

Calcium Channel BlockersDownload File
(Calcium channel blocker formulary review 24 June 14.pdf)

Date Uploaded: 24/06/2014

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Review of hypertension management in newly diagnosed patients

The aim of this audit is to review patients diagnosed with hypertension in the past 6 months to ensure treatment is prescribed as per the NICE clinical guideline 127.

Review of hypertension management in newly diagnosed patientsDownload File
(Medicines_Management_hypertension_review[1]_1.pdf)

Date Uploaded: 23/06/2014

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Review of MR Dipyridamole for secondary prevention of occlusive events in patients with a history of ischaemic stroke or TIA

This audit protocol supports the review of patients who are taking Dipyridamole MR for the secondary prevention of occlusive events following ischaemic stroke, TIA or amaurosis fugax.

Review of MR Dipyridamole for secondary prevention of occlusive events in patients with a history of ischaemic stroke or TIADownload File
(Dipyridamole in ischaemic stroke review.pdf)

Date Uploaded: 30/04/2012

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Diltiazem Review

Diltiazem is available as a number of modified release products. In NHS D&G the formulary options are Zemtard XL and Angitil SR capsules. This review aims to increase formulary complaince with these products.

Diltiazem ReviewDownload File
(Diltiazem SR & XL Review Aug2011.pdf)

Date Uploaded: 22/09/2011

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ARB Formualry Adherence

This audit supports evidence based prescribing in line with NHS D & G joint formualry 2011 for the purpose of treating patients with hypertension intolerant of ACE inhibitors.

ARB Formualry AdherenceDownload File
(ARB switch June 2011.pdf)

Date Uploaded: 05/08/2011

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Nifedipine immediate release review protocol

Immediate release nifedipine capsules are associated with baroreflex sympathetic activation and tachycardia. In the 1990s concerns were raised that short-acting nifedipine increased cardiovascular and overall mortality. Modified-release preparations of nifedipine are designed to produce a more gradual change in blood pressure and cause less sympathetic activation.

Patients treated with nifedipine immediate-release capsules will be considered for Adipine (slow release nifedipine) or amlodipine.

Nifedipine immediate release review protocolDownload File
(Nifedipine immediate release review protocol.pdf)

Date Uploaded: 01/08/2011

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Doxazosin Review

The objective of this audit is to identify patients suitable to be switched from Cardura XL to standard release generic doxazosin.

Doxazosin ReviewDownload File
(Cardura XL audit 2011.pdf)

Date Uploaded: 17/05/2011

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Review of aspirin prescribing

Recommendations from a number of sources have resulted in some patients being prescribed and receiving a daily dose of aspirin other than 75mg. This audit seeks to rationalise the prescribing of aspirin and will highlight patients eligible for a change of dose and patients who are not requesting antiplatelet medication on a regular basis.

Review of aspirin prescribingDownload File
(Aspirin Dose Audit Sept 2010.pdf)

Date Uploaded: 01/10/2010

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Ezetimibe Review Protocol

In NHS D & G ezetimibe is recommended in addition to a statin therapy only where cholesterol levels cannot be achieved by optimum statin use or where statin use is contra-indicated or not tolerated.


Ezetimibe Review ProtocolDownload File
(Ezetimibe review document.pdf)

Date Uploaded: 09/06/2010

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Amlodipine Switch protocol

Amlodipine is currently the most cost effective calcium channel blocker for the treatment of hypertension and angina.
This switch protocol sets out the process for switching patients currently being treated with felodipine to amlodipine but can be used as a template for other CCB switches if dose equivalence information is available.


Amlodipine Switch protocolDownload File
(Amlodipine Switch protocol May 2010.pdf)

Date Uploaded: 03/06/2010

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Co-prescribing of clopidogrel and PPIs

There is evidence to suggest that proton pump inhibitors (PPIs) interfere with the metabolism of clopidogrel to the active metabolite through the inhibition of the cytochrome P450 enzyme (CYP2C19).This protocol supports the medication review of patients co-prescribed clopidogrel and a PPI.

Co-prescribing of clopidogrel and PPIsDownload File
(Clopidogrel & PPI review Sept 2009.pdf)

Date Uploaded: 12/06/2009

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Adherence to SIGN guidelines for Stable Angina

SIGN Guideline No. 96 Management of stable angina, makes recommendations on the pharmacological treatment of all patients with stable angina. This audit has been designed to review all patients on the practice list who have a diagnosis of stable angina/ischaemic heart disease to determine if their treatment is in line with these guidelines.

Adherence to SIGN guidelines for Stable AnginaDownload File
(Adherence to SIGN guidelines for Stable angina Sept 09.pdf)

Date Uploaded: 16/07/2008

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Isosorbide mononitrate

Oral nitrates are effective as long-term symptomatic therapy when used once daily as a sustained release preparation, or as an asymmetric twice-daily preparation (e.g. 8 a.m. and 2 p.m.). Both isosorbide dinitrate and isosorbide mononitrate have been shown in controlled trials to be superior to placebo in controlling symptomatic angina (1).

Standard tablets of isosorbide mononitrate (ISMN) have been shown to reduce tolerance when given twice daily using an asymmetric dosing interval. This allows a nitrate-free period of 6 to 8 hours. (2). SIGN 5I recommended that oral nitrates can be used as a satisfactory monotherapy in the treatment of long-term angina symptoms (1) provided it is used in a way which avoids nitrate tolerance (e.g. in an asymmetric dose schedule).


Isosorbide mononitrateDownload File
(isosorbide mono nitrate review Sept 2009.pdf)

Date Uploaded: 11/04/2008

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ACE inhibitors in the treatment of stable angina

SIGN Guideline No. 96 Management of stable angina1, states that all patients with stable angina would benefit from taking an ACE Inhibitor. This audit has been designed to review all patients on the practice list who have a diagnosis of stable angina so that they may be considered for treatment with an ACE Inhibitor if they are not already taking one.

ACE inhibitors in the treatment of stable anginaDownload File
(ACE Inhibitors in stable angina[1].pdf)

Date Uploaded: 31/12/2007

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Amiodarone Safety Audit

An audit to ensure that the prescribing of Amiodarone in general practices in Dumfries and Galloway follows SIGN 94 guideline (Cardiac Arrhythmias in Coronary Heart Disease) recommendations regards monitoring of TFTs and LFTs.

Amiodarone Safety AuditDownload File
(Amiodarone review Sept 2009.pdf)

Date Uploaded: 31/12/2007

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