Quality standard

Quality statement 5: Symptoms not responding to treatment

Quality statement

People with stable angina whose symptoms have not responded to treatment are offered a re-evaluation of their diagnosis and treatment.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that people with stable angina whose symptoms have not responded to treatment are offered a re-evaluation of their diagnosis and treatment.

Data source: Local data collection.

Process

Proportion of people with stable angina whose symptoms have not responded to treatment who have their diagnosis and treatment re-evaluated.

Numerator – the number of people in the denominator who have their diagnosis and treatment re-evaluated.

Denominator – the number of people with stable angina whose symptoms have not responded to treatment.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure systems are in place to re-evaluate the diagnosis and treatment of people with stable angina whose symptoms have not responded to treatment.

Healthcare professionals offer re-evaluation of diagnosis and treatment to people with stable angina whose symptoms have not responded to treatment.

Commissioners ensure they commission services that re-evaluate the diagnosis and treatment of people with stable angina whose symptoms have not responded to treatment.

People with stable angina whose symptoms are not improving with treatment are offered a re-evaluation of their diagnosis and treatment.

Source guidance

Stable angina: management. NICE guideline CG126 (2010, updated 2016), recommendation 1.7.1.

Definitions of terms used in this quality statement

Re-evaluation of diagnosis and treatment

Comprehensive re-evaluation and advice may include:

  • exploring the person's understanding of their condition

  • exploring the impact of symptoms on the person's quality of life

  • reviewing the diagnosis and considering non-ischaemic causes of pain

  • reviewing drug treatment and considering future drug treatment and revascularisation options

  • acknowledging the limitations of future treatment

  • explaining how the person can manage the pain themselves

  • specific attention to the role of psychological factors in pain

  • development of skills to modify cognitions and behaviours associated with pain.

[Adapted from NICE's guideline on stable angina, recommendation 1.7.1]