Completing the audit cycle : comparison of cardiac risk factor management in patients with intermittent claudication in two time periods

Abstract

Aim. The first line treatment of patients with intermittent claudication (IC) is to prolong life via cardiac risk factor management. We aimed to compare current standards of secondary prevention with those in a previously published audit. Methods. Risk factor data was prospectively collated on 304 consecutive new referrals attending the claudication clinic over a 1-year period (2004/2005) and compared to the 104 patients assessed in 2000. Results. In 2004/5 30%, (n=91) of patients did not have a diagnosis of IC confirmed (p < 0.01). The use of antiplatelet therapy remained static at 73%. Statin therapy increased in 2004/5 (62% versus 38%, p < 0.01) but blood pressure control remained poor with 65% failing to achieve the target levels. Smoking cessation therapy continues to be offered to a minority of patients and 17% of patients have previously undiagnosed diabetes in 2004/2005 (p-value 0.353). The number of patients who have been advised to increase physical activity significantly has fallen from 15% to 2% in the 2004/5 (p < 0.01). Conclusions. Difficulties exist in diagnosing intermittent claudication in primary care and cardiac risk factor manage- ment continues to be sub-optimally managed.