ABSTRACT NUMBER: ESOC2026A2366 IMPROVING THE PRIMARY PREVENTION OF STROKE IN PATIENTS DURING COPD REVIEW CLINICS IN THE PRIMARY CARE SETTING

Abstract Background and aims COPD is associated with a significantly increased risk of cardiovascular diseases (CVD) including stroke.[1] The risk of MACE increases dramatically after an acute exacerbation of COPD. COPD has been identified in the UK based QRISK4 primary prevention calculator as an independent risk factor for atherosclerotic diseases.[2] This presents a unique opportunity to offer lipid lowering therapy (LLT) to patients with COPD. A real-world primary care-based service evaluation was undertaken to consider the feasibility of offering LLT during routine COPD reviews. Methods LLT naive patients with COPD were offered therapy during routine nurse-delivered COPD reviews. Risk of CVD, including stroke, was discussed and individuals wanting LLT were directed either to the primary care pharmacist or GP for prescription, or further discussion and prescription if mutually agreed. Furthermore, patients were also checked for the presence of atrial fibrillation and heart failure. Results Of the initial 60 patients reviewed in the programme, 38 (63%) were already taking LLT. The 22 (37%) patients not taking LLT were offered medicines to reduce their lipid burden with a view to lowering CVD risk. 10 of the 22 patients were prescribed LLT, 10 declined LLT and 2 requested further blood testing. The opportunistic approach increased lipid lowering prescribing in the LLT naive cohort by 45%. Conclusions Primary care-based COPD review clinics provide an ideal setting to offer LLT and potentially reduce the risk of stroke. We advise routine proactive CVD risk reduction as standard practice during COPD reviews in the primary care setting. Conflict of interest The speaker has received honoraria from: Abbott | Amarin | Amgen | AstraZeneca | Bayer | Boehringer Ingelheim | Daiichi Sankyo | Edwards | Medtronic | Novartis | Omron