Frontiers in pharmacology · 2026
Improving lipid-lowering treatment and cardiovascular risk management in primary care: findings from an audit and feedback project.
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Rottura Michelangelo, Francesca Anna Drago Selene, Molonia Antonino, Gianguzzo Viviana Maria, Sacco Federica Maria, Pallio Giovanni, Irrera Natasha, Scoglio Riccardo, Marino Sebastiano, Corrao Salvatore, Mandraffino Giuseppe, Imbalzano Egidio, Arcoraci Vincenzo
Аннотация
INTRODUCTION: Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. Low-density lipoprotein cholesterol (LDL-C) plays a central role in atherogenesis and cardiovascular events. In real-world primary care, many patients at high and very-high cardiovascular risk (HCVR) do not achieve recommended LDL-C targets.
OBJECTIVES: This study evaluated whether an audit and feedback (A&F) intervention could improve lipid management in HCVR patients managed in general practice.
METHODS: We conducted a retrospective-prospective observational study involving general practitioners (GPs). GPs were classified as active, participating in A&F training and feedback sessions, or controls, contributing data only. Patient-level data were extracted from electronic medical records across three 18-month observation periods (T0, T1, and T2). Active GPs received tailored performance reports and educational sessions after T0 and T1. Main outcomes included completeness of clinical data recording, LDL-C target attainment (<70 mg/dL), lipid-lowering treatment patterns, and treatment adherence.
RESULTS: Compared with baseline, active GPs showed significant improvements in the recording of LDL-C (+18.3%), HbA1c (+5.7%), body mass index (+17.1%), smoking status (+4.4%), and alcohol consumption (+14.4%). LDL-C target attainment increased from 6.1% at T0 to 14.5% at T2, exceeding the proportion observed in controls at T2 (8.7%). The use of lipid-lowering therapy among active GPs increased from 48.9% at T0 to 61.3% at T2, while high-intensity therapy increased from 9.1% to 17.6%. Treatment adherence improved over time, with a higher proportion of patients adherent to high-intensity therapy and a reduction in non-adherent low-intensity therapy.
CONCLUSION: An audit and feedback intervention supported by a multidisciplinary team improved data completeness and lipid management in high-risk patients in the primary care setting.
OBJECTIVES: This study evaluated whether an audit and feedback (A&F) intervention could improve lipid management in HCVR patients managed in general practice.
METHODS: We conducted a retrospective-prospective observational study involving general practitioners (GPs). GPs were classified as active, participating in A&F training and feedback sessions, or controls, contributing data only. Patient-level data were extracted from electronic medical records across three 18-month observation periods (T0, T1, and T2). Active GPs received tailored performance reports and educational sessions after T0 and T1. Main outcomes included completeness of clinical data recording, LDL-C target attainment (<70 mg/dL), lipid-lowering treatment patterns, and treatment adherence.
RESULTS: Compared with baseline, active GPs showed significant improvements in the recording of LDL-C (+18.3%), HbA1c (+5.7%), body mass index (+17.1%), smoking status (+4.4%), and alcohol consumption (+14.4%). LDL-C target attainment increased from 6.1% at T0 to 14.5% at T2, exceeding the proportion observed in controls at T2 (8.7%). The use of lipid-lowering therapy among active GPs increased from 48.9% at T0 to 61.3% at T2, while high-intensity therapy increased from 9.1% to 17.6%. Treatment adherence improved over time, with a higher proportion of patients adherent to high-intensity therapy and a reduction in non-adherent low-intensity therapy.
CONCLUSION: An audit and feedback intervention supported by a multidisciplinary team improved data completeness and lipid management in high-risk patients in the primary care setting.