Implementing Evidence-Based Lipid Disorder Management Protocols at a Cardiology Unit in Abuja: A Biochemical Audit

Optimal management of lipid disorders in patients with established or high-risk cardiovascular disease requires evidence-based treatment targets driven by serial biochemical monitoring, and an audit of current lipid disorder management practice at a cardiology unit provides the foundation for quality improvement. This study conducts a biochemical audit of lipid disorder management at the cardiology unit of the National Hospital Abuja over an eighteen-month period, examining adherence to current guideline-recommended biochemical targets and monitoring frequencies. Three hundred and twenty patient records of individuals with established cardiovascular disease or high cardiovascular risk were reviewed. Audit data extracted included baseline and serial LDL-C measurements, attainment of guideline-recommended LDL-C targets below 1.8 millimoles per litre for very high-risk patients and below 2.6 millimoles per litre for high-risk patients, lipid monitoring frequency, prescription of statin therapy, and documentation of statin dose titration in response to biochemical results. Results show that LDL-C attainment of the very high-risk target was achieved in only 34 percent of eligible patients. Lipid monitoring at six-month intervals was achieved in 58 percent of patients on statin therapy. Dose titration in response to inadequate LDL-C response was documented in 41 percent of patients not at target. Non-statin lipid-lowering therapy was rarely prescribed despite persistent suboptimal LDL-C. The audit reveals substantial gaps between guideline recommendations and clinical practice. A targeted quality improvement intervention including prescriber education and a biochemical result-driven clinical alert system is recommended. Keywords: lipid disorder management, cardiovascular disease, LDL-C, clinical audit, Abuja.