06 October 2023

Audit with a GP practice

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Upper Sixth student Narada Peiris recently undertook an audit with a GP practice, screening patients with a particular condition (psoriasis) who are at heightened risk of other conditions. The audit identified a number of patients with hitherto undiagnosed conditions, which can now be treated early, so Narada’s work has had a genuine real-world impact.

While doing my own reading and research, I noticed that recent studies showed a greater risk of cardiovascular diseases in patients with psoriasis. Having experience of a similar skin condition, this interested me, and I felt compelled to act.

During the summer, I performed an audit at a GP practice where I screened for patients that had not received a score for their cardiovascular risk. Thirty-three patients were consequently scheduled for blood tests and a GP appointment to assess their cardiovascular risk. This was calculated through a tool called QRISK2, which combines a patient’s history and blood results to calculate the probability of a cardiovascular event over the next ten years.

Three patients were found to have a score ≥10%, meaning that statin treatment could be prescribed to reduce their cardiovascular risk. Furthermore, one patient was found to have type 2 diabetes, for whom the GP gave further management advice.

Following the practice of the European Society of Cardiology, I proposed a modification for how cardiovascular risk was calculated; the scores should be multiplied by 1.5 to account for psoriasis being an independent risk factor. I also discussed with the GPs that it would be important to assess the cardiovascular risk for these patients every five years. Now, I have summarised my findings and taken steps to disseminate information leaflets to other GP practices in Kent.

Overall, I was happy to have made a difference in these patients’ lives, as well as encouraging improved care for them.

Narada Peiris, Upper Sixth

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