54 Evaluating Best Medical Therapy Provision in Peripheral Arterial Disease Patients: A Prospective Audit

Abstract

Abstract Background Best medical therapy (BMT) is a collection of evidence-based cost-effective interventions, which significantly decreases cerebrovascular and coronary mortality and morbidity risk by at least 20% in peripheral arterial disease (PAD) patients. Its implementation was audited in patients attended our vascular unit. Method A prospective audit of BMT implementation in PAD patients in University Hospital Ayr over a three-week period: diabetic and hypertension control, statin and antiplatelet therapy were audited from electronic notes and prescription charts. Exercise and smoking cessation advice given during consultations was recorded and audited. Results 35 patients were randomly selected from ward admissions and vascular clinics. Their mean age was 69±12, 25 were male. 4 out of 11 current smokers received smoking cessation advice. All the patients attending the vascular clinic were given exercise advice. 3 patients had never had their HbA1c checked. 7 of 14 diabetic patients with poor control had changes to their medication. Stains were started in 7 out of 14 patients not currently on a statin and another 4 patients had their statin dose increased. 32 patients had their lipid profile checked. Both patients with newly diagnosed hypertension were not prescribed antihypertensive. Only 5 out of 12 patients who should have had an antiplatelet agent received them. 5 patients were changed from a single antiplatelet agent to dual therapy. Conclusions Primary and secondary care education is essential to improve BMT provision in PAD patients.