Quality statement 4: Assessing cardiovascular risk

Quality statement

Adults with severe psoriasis are offered a cardiovascular risk assessment at diagnosis and at least once every 5 years.

Rationale

Adults with severe psoriasis are at increased risk of cardiovascular disease. Assessing cardiovascular risk in this group allows appropriate intervention for modifiable risk factors such as smoking, alcohol use or high blood pressure to be offered.

Quality measures

Structure

Evidence of local arrangements for adults with severe psoriasis to receive a cardiovascular risk assessment at diagnosis and at least once every 5 years.

Data source: Local data collection.

Process

a) Proportion of adults with severe psoriasis who receive a cardiovascular risk assessment at diagnosis.

Numerator – the number of people in the denominator who receive a cardiovascular risk assessment at diagnosis.

Denominator – the number of adults diagnosed with severe psoriasis.

Data source: Local data collection. Contained in NICE clinical guideline 153 audit support for non-specialist services.

b) Proportion of adults with severe psoriasis diagnosed more than 5 years ago whose most recent cardiovascular risk assessment was within 5 years of diagnosis or the previous assessment.

Numerator – the number of people in the denominator whose most recent cardiovascular risk assessment was within 5 years of diagnosis or the previous cardiovascular risk assessment.

Denominator – the number of adults with severe psoriasis diagnosed more than 5 years ago.

Data source: Local data collection. Contained in NICE clinical guideline 153 audit support for non-specialist services.

What the quality statement means for service providers, healthcare practitioners, and commissioners

Service providers ensure that systems are in place for adults with severe psoriasis to be offered a cardiovascular risk assessment at diagnosis and at least once every 5 years.

Healthcare practitioners ensure that adults with severe psoriasis are offered a cardiovascular risk assessment at diagnosis and at least once every 5 years.

Commissioners ensure that they commission services for adults with severe psoriasis to be offered a cardiovascular risk assessment at diagnosis and at least once every 5 years.

What the quality statement means for patients, service users and carers

Adults with severe psoriasis are offered an assessment of their risk of having heart problems when they are diagnosed and at least once every 5 years.

Source guidance

Psoriasis: assessment and management (2012, updated 2017) NICE guideline CG153, recommendation 1.2.3.1

Definitions of terms used in this quality statement

Severe psoriasis can be defined as psoriasis that needs, or is likely to need, treatment with phototherapy or systemic agents, or needs hospital admission.

Cardiovascular risk assessment Some validated cardiovascular risk estimation tools for use with adults exclude younger and older people.