Abstract Background The National Audit of Cardiovascular Disease (CVD) Prevention in Primary Care (CVDPREVENT) in England measures & reports data on CVD prevention activity particularly around six high-risk conditions for CVD including: atrial fibrillation (AF), hypertension, hypercholesterolaemia, chronic kidney disease (CKD), non-diabetic hyperglycaemia and diabetes. Purpose/Aim CVDPREVENT supports the health system to understand how many people may be undiagnosed or under-treated for the high-risk conditions across England (Figure 1). The audit also supports systematic quality improvement (QI) to reduce health inequalities & improve outcomes for individuals & populations. Method Data is extracted quarterly from GP clinical systems in England on people with a diagnosis of any of the high-risk conditions, a prior diagnosis of CVD, or test results indicative of a high-risk condition without diagnosis. Along with clinical history such as prescribed medication and clinical tests, demographic information is collected to provide insights into potential health inequalities. CVDPREVENT cohorts are also linked to admissions (Hospital Episode Statistics) and mortality (Office for National Statistics) data to understand their outcomes across year-long periods. Results Data from across 98% of English GPs were extracted in Mar 2024 (12.7M patients were diagnosed with CVD or one of the high-risk conditions) showing performance across a wide range of CVD indicators. Improvements were seen in the management of many high-risk conditions when compared to the previous year (Table 1). An additional 346K people were diagnosed with hypertension between Mar 2023 and Mar 2024. Variation between the best- and worst-performing healthcare systems for the hypertension treated to target indicator narrowed between Mar 2021 (range 39-52%) and Mar 2024 (range 66-74%). Other findings highlight health inequalities. For instance, black and mixed ethnic groups were least likely to be prescribed appropriate drug therapy, receive regular monitoring or be treated to target across multiple conditions and indicators. Eg. 80% of patients with CVD in black ethnic group prescribed a LLT compared to 90% in the Asian ethnic group in March 2024. With respect to deprivation, when CVDPREVENT cohorts are linked to outcomes data, the highest mortality and admission rates (for heart attacks and strokes) were shown in the most deprived quintile, trending down to the lowest rates in the least deprived quintile, after adjusting for age. Conclusion Robust, timely & regular primary care data collection and reporting is essential to understanding progress towards CVD prevention ambitions and therefore the prevention of death & disability. Reporting of CVDPREVENT data has highlighted variation between local areas as well as demographic groups which has been utilised locally in QI approaches and influencing national policy. Data-driven improvement ensures that efforts are systematic and high-impact.Figure 1.Purpose of CVDPREVENT audit Examples of CVDPREVENT indicators
Girling et al. (Sat,) studied this question.