Table 1.
Twenty-six Quality indicators for management of cardiovascular diseases.
| Secondary Prevention in Coronary Heart Disease (Description of Indicators) | Points* | Target** |
| CHD 2. The percentage of patients with newly diagnosed angina (diagnosed after 01/04/03) who are referred for exercise testing and/or specialist assessment | 7 | 90% |
| CHD 3. The percentage of patients with coronary heart disease, whose notes record smoking status in the past 15 months, except those who have never smoked where smoking status need be recorded only once | 7 | 90% |
| CHD 4. The percentage of patients with coronary heart disease who smoke, whose notes contain a record that smoking cessation advice has been offered within the last 15 months | 4 | 90% |
| CHD 5. The percentage of patients with coronary heart disease whose notes have a record of blood pressure in the previous 15 months | 7 | 90% |
| CHD 6. The percentage of patients with coronary heart disease, in whom the last blood pressure reading (measured in the last 15 months) is 150/90 or less | 19 | 70% |
| CHD 7. The percentage of patients with coronary heart disease whose notes have a record of total cholesterol in the previous 15 months | 7 | 90% |
| CHD 8. The percentage of patients with coronary heart disease whose last measured total cholesterol (measured in the last 15 months) is 5 mmol/l or less | 16 | 60% |
| CHD 9. The percentage of patients with coronary heart disease with a record in the last 15 months that aspirin, an alternative anti-platelet therapy, or an anti-coagulant is being taken (unless a contraindication or side effects are recorded) | 7 | 90% |
| CHD 10. The percentage of patients with coronary heart disease who are currently treated with a beta blocker (unless a contraindication or side-effects are recorded) | 7 | 50% |
| CHD 11. The percentage of patients with a history of myocardial infarction (diagnosed after 1 April 2003) who are currently treated with an ACE inhibitor | 7 | 70% |
| CHD 12. The percentage of patients with coronary heart disease who have a record of influenza vaccination in the preceding 1 September to 31 March | 7 | 85% |
| Subset – Left Ventricular Dysfunction | ||
| LVD 2. The percentage of patients with a diagnosis of CHD and left ventricular dysfunction (diagnosed after 1/4/03) which has been confirmed by an echocardiogram | 6 | 90% |
| LVD 3. The percentage of patients with a diagnosis of CHD and left ventricular dysfunction who are currently treated with ACE inhibitors (or A2 antagonists) | 10 | 70% |
| Stroke or transient ischemic attacks | ||
| CVA 2. The percentage of new patients with presumptive stroke (presenting after 01/04/03) who have been referred for confirmation of the diagnosis by CT or MRI scan | 2 | 80% |
| CVA 3. The percentage of patients with TIA or stroke who have a record of smoking status in the last 15 months, except those who have never smoked where smoking status should be recorded at least once since diagnosis | 3 | 90% |
| CVA 4. The percentage of patients with a history of TIA or stroke who smoke and whose notes contain a record that smoking cessation advice has been offered in the last 15 months | 2 | 70% |
| CVA 5. The percentage of patients with TIA or stroke who have a record of blood pressure in the notes in the preceding 15 months | 2 | 90% |
| CVA 6. The percentage of patients with a history of TIA or stroke in whom the last blood pressure reading (measured in the last 15 months) is 150/90 or less | 5 | 70% |
| CVA 7. The percentage of patients with TIA or stroke who have a record of total cholesterol in the last 15 months | 2 | 90% |
| CVA 8. The percentage of patients with TIA or stroke whose last measured total cholesterol (measured in the last 15 months) is 5 mmol/l or less | 5 | 60% |
| CVA 9. The percentage of patients with a stroke shown to be nonhemorrhagic, or a history of TIA, who have a record that aspirin, an alternative anti-platelet therapy, or an anti-coagulant is being taken (unless a contraindication or side-effects are recorded) | 4 | 90% |
| CVA 10. The percentage of patients with TIA or stroke who have had influenza immunization in the preceding 1 September to 31 March | 2 | 85% |
| Hypertension | ||
| BP 2. The percentage of patients with hypertension whose notes record smoking status at least once | 10 | 90% |
| BP 3. The percentage of patients with hypertension who smoke, whose notes contain a record that smoking cessation advice has been offered at least once | 10 | 90% |
| BP 4. The percentage of patients with hypertension in which there is a record of the blood pressure in the past 9 months | 20 | 90% |
| BP 5. The percentage of patients with hypertension in whom the last blood pressure (measured in last 9 months) is 150/90 or less | 56 | 70% |
*For each indicator practice could achieve from 0 up to 56 points – as specified for each indicator. **Percentage of patients that needed to be reviewed to receive maximum points for an indicator (as specified in the points column). All minimum threshold targets for payment are 25%.
Abbreviations: BP – Hypertension, CHD – Coronary Heart Disease, LVD – Left Ventricular Dysfunction, CVA – Cerebral Vascular Accident;