Abstract
Introduction:
The Northern England Evaluation and Lipid Intensification (NEELI) guidelines recommend that for secondary prevention after stroke and transient ischemic attack (TIA), the lipid profile should be checked within 24 hours of admission and atorvastatin 80 mg should be started once daily. If the starting dose was lower than 80 mg, plans should be made for statin uptitration in three months. The aim is to evaluate adherence to NEELI guidelines on checking lipid profile and prescribing statin therapy for optimal secondary prevention after stroke or TIA.
Methodology:
This is a retrospective study. A random sample of 51 and 48 patients was selected for the first and second cycles, respectively, taking into consideration the inclusion criteria. Statins prescriptions during admission were reviewed, and plans for uptitration in the community. The audit has examined the lipid profile checks and whether they were performed within 24 hours of admission. The audit was conducted in two cycles: before and after the implementation of the intervention. The intervention involved conducting ward teaching on optimal lipid management and NEELI guidelines after the first cycle to raise awareness among doctors.
Results:
During the first cycle, a 74% gap was identified in prescribing the correct dose of statins. Seventy- three percent of patients had their lipid profile checked during admission, with 95% of these tests completed within the first 24 hours. Only 8% had plans for statin uptitration in the community. On the second cycle, the gap in prescribing statins decreased to 73%. Lipid profile checks increased to 79%, with 81% completed within the first 24 hours. Documentation of plans for statin uptitration increased to 26%.
Conclusion:
Improvement in guideline compliance was noted, accompanied by a slight decrease in lipid checks within 24 hours. Plans are to continue regular ward teaching and provide posters.