Objective: The objective of this study was to test the effectiveness of an audit programme for dyslipidaemia management in a primary care setting in Macau.
Design: A quality improvement study based on an evaluation of a before-after intervention trial was conducted in 2017-2018. Interventions comprising feedback from an audit, general practitioner (GP) training via interactive workshops and one-on-one case discussions were implemented. The primary outcome measure was the proportion of patients with reasonable management of dyslipidaemia, and the secondary outcome measure was the proportion of patients with low-density lipoprotein cholesterol (LDL-C) meeting the target recommended by the Adult Treatment Panel III guidelines.
Setting: This study was conducted at the Sao Lourenco Health Center, one of the health centres in the Macau primary care system; this centre provides primary care services to one-tenth of the residents of Macau.
Participants: All GPs who worked in the Sao Lourenco Health Center participated in the study. We systematically reviewed 100 patient records from each participating physician's patient list. In total, 1200 and 1100 patient records were reviewed before and after the intervention, respectively.
Results: At baseline, 390 (43.5%) patients were eligible for statin therapy, while 411 (47.7%) patients were eligible for statin therapy in the reaudit group (p=0.08). After intervention, the proportion of patients with reasonable management of dyslipidaemia increased from 83.9% to 88.5% (p=0.005), and the proportion of eligible patients with LDL-C levels meeting the target increased from 55.1% to 65% (p=0.004).
Conclusions: The audits and feedback significantly improved dyslipidaemia management in the Macau primary care setting.
Keywords: ATP III guidelines; clinical audit; dyslipidemias; quality improvement.
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