We've had a number of support tickets around both achievement and exclusion in the new CHOL domain, we thought it would be useful to try and simplify both indicators for you:
CHOL001 - Patients with CHD/PAD/STIA/CKD - Prescribed Statin or alternative lipid-lowering therapy (FYI - Diabetics are auto excluded from indicator (Statin indicator already in diabetes))
Achievement:
- Stain Prescribed in L6M QOF Year
- or Statin PCA (Tolerance/Contraindication/Declined) and prescribed an alternative (Bempedoic Acid/Ezetimibe/Icosapent ethyl/Inclisiran/PCS) - Important that a Statin PCA is applied otherwise a patient won't achieve if prescribed alternative
PCA's:
- Individual PCA codes for each drug: tolerance/contraindications/allergies/declined codes required against all 6 drug categories
- Top level PCA codes: lipid-lowering therapy declined/not tolerated/contraindicated - one code removes patient if no medication can be prescribed at all
- Maximum Tolerated Cholesterol Lowering Dose code L12M
- Palliative Care patients are excluded
- No non-responder pathway
CHOL002 - Patients with CHD / PAD / STIA - non-HDL cholesterol <2.5 or LDL cholesterol <1.8 if a non-HDL test has not been performed in last 12M
Achievement:
- non-HDL blood test result <2.5 in this QOF Year
- or if no non-HDL result this year an LDL cholesterol value <1.8. LDL results will only count if a non-HDL blood has not been recorded
PCA's:
- Blood test declined - only PCA available
- No non-responder pathway
- No other exclusions