14th Annual Conference of the British HIV Association 23-25 April 2008, Belfast

IDENTIFYING PATIENTS FOR CARDIOVASCULAR RISK REDUCTION IN A SPECIALIST METABOLIC CLINIC

HIV Med 2008 Apr 23-25 (Suppl 1);14:14 (abstract no. P16)

C Stradling and M Roos
Heart of England NHS Trust, Birmingham, UK

BACKGROUND: A CV risk assessment screening pathway was developed directing referals to a monthly HIV Metabolic clinic, established by a specialist physician and dietitian. Aims: To evaluate validity of CV screening pathway; to examine appropriateness of referals to metabolic clinic; to assess effect of clinic interventions in reducing CV risk.

METHODS: Retrospective analysis of patients notes attending metabolic clinic since 2006, with data collected on reason for referral, CV risk pre and post attendance at MC. This was compared to patient data from the CVD screening database.

RESULTS:Of the 187 patients screened (16%) 30 (all men) were identified as high risk for CVD (>20% 10 year risk) but only 12 (23%) were subsequently referred to metabolic clinic. Of the 48 patients seen in metabolic clinic, 81% were men, 47% were high risk (>20% 10 year CV risk), 37% at moderate risk (10-20% 10 year CV risk). Referral route was primarily via the screening process or because patients were already on statins. Only 10% were referred inappropriately due to hyperlipidaemia rather than CV risk. The mean change in CV risk from before attending metabolic clinic to after interventions was –1.6%.

CONCLUSIONS: This audit suggests that a specialist HIV metabolic clinic can be effective in reducing CV risk. The screening process facilitates appropriate referals, but the delay between identification of risk and referal to MC requires addressing. It may be due to interim lifestyle intervention appointments and attempting to sychronise patient clinic visits. Revisions are proposed to the pathway for CV screening and risk modification to enable future optimal management.

2008-04-23
P16

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