Quality statement 2: Comorbidity assessment

Quality statement

People with peripheral arterial disease (PAD) are offered an assessment for cardiovascular comorbidities and modifiable risk factors.

Rationale

People with both asymptomatic and symptomatic PAD have an increased risk of mortality from cardiovascular disease, mainly due to heart attack and stroke. It is therefore important to assess people with PAD for other cardiovascular comorbidities and modifiable risk factors, so that appropriate evidence-based treatment, advice and support can be given to reduce this risk.

Quality measures

Structure

Evidence of local arrangements to ensure that people with PAD are offered an assessment of cardiovascular comorbidities and modifiable risk factors.

Data source: Local data collection.

Process

Proportion of people with PAD who receive an assessment of cardiovascular comorbidities and modifiable risk factors.

Numerator – the number of people in the denominator receiving an assessment of cardiovascular comorbidities and modifiable risk factors.

Denominator – the number of people with PAD.

Data source: Local data collection. Data on the percentage of patients with PAD in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less, the percentage of patients with PAD in whom the last measured total cholesterol (measured in the preceding 12 months) is 5 mmol/l or less, and the percentage of patients with PAD with a record in the preceding 12 months that aspirin or an alternative antiplatelet is being taken, are available in the Quality and Outcomes Framework (QOF) indicators PAD002, PAD003 and PAD004.

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

Service providers ensure that staff are trained to carry out assessments for cardiovascular comorbidities and modifiable risk factors.

Healthcare practitioners ensure that they offer people with PAD an assessment for cardiovascular comorbidities and modifiable risk factors.

Commissioners ensure that they commission services so that staff are trained on how to assess for cardiovascular comorbidities and modifiable risk factors.

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

People with peripheral arterial disease are offered an assessment to check their risk of having a heart attack or a stroke, and identify any lifestyle factors that they can alter to reduce their risk (for example, eating healthily, reducing alcohol consumption, stopping smoking, maintaining a healthy weight and exercising regularly).

Source guidance

  • Lower limb peripheral arterial disease (NICE clinical guideline 147), recommendation 1.2.1 (key priority for implementation).

Definitions of terms used in this quality statement

The assessment of cardiovascular comorbidities and modifiable risk factors should include a review of:

  • smoking status

  • diet

  • weight

  • cholesterol levels

  • presence of diabetes

  • presence of hypertension

  • current antiplatelet therapy.

[Adapted from NICE clinical guideline 147, recommendation 1.2.1]