Quality improvement audit on cardiovascular disease risk management in patients with type II diabetes mellitus

Abstract

Introduction: The American Diabetes Association standards of care 2021 recommend statins for all patients with diabetes mellitus aged 40 to 75 years. This quality improvement audit was done to improve adherence to these guidelines in the Internal Medicine outpatient clinic of Patan Academy of Health Sciences, Nepal. Methods: This study was conducted according to the Plan-Do-Study-Act (PDSA) cycle. All patients aged 40 to 75 years with type 2 diabetes mellitus were included. Pregnant patients were excluded from study. A baseline study was conducted in the outpatient internal medicine clinic of Patan Academy of Health Sciences, Nepal, from 2021 October 18 to 2021 October 25, on all eligible patients. Based on the results, objectives were set to ensure that 90% of patients in the OPD with diabetes mellitus receive statin when indicated and that at least 50% of patients with diabetes mellitus receive the dose per ASCVD risk. The intervention was through pamphlets, department presentations, and formal and informal feedback. A post-intervention follow-up study was conducted from 4th September to 9th September 2022, at the same site. Results: Patients who were taking statins increased from 46% (N=54) to 95% (N=41). Patients who were taking appropriate doses of statins increased from 24% (N=54) to 80% s(N=41). Conclusions: Considering the potential benefits and the project’s initial success, we recommend continuing the project and considering it in other centers as well.