Lipid Modification Therapy : Follow up

This table serves as a quick reference guide for primary care clinicians in the management and follow-up of patients who have been initiated on lipid modification therapy for primary prevention. It outlines what to do in various scenarios such as inadequate response to therapy, occurrence of adverse effects, and the need for ongoing monitoring: in accordance with NICE guidance

Key Points	Actions	Notes
Initial Check at 3 Months	Measure total cholesterol, HDL-C, and non-HDL cholesterol levels	-
Inadequate Response (Less than 40% reduction in non-HDL-C)	1. Discuss adherence and dose timing 2. Optimize diet and lifestyle measures 3. Consider dose escalation of atorvastatin	Only escalate dose for higher-risk individuals
Persistently Inadequate Response	Consider adding ezetimibe to atorvastatin	Seek specialist advice if required
Liver Function Monitoring	Recheck LFTs at 3 and 12 months	Additional tests only if clinically indicated
Annual Review	1. Discuss adherence and lifestyle modification 2. Address CVD risk factors 3. Consider non-fasting blood test for non-HDL-C	-
Changing Statin Intensity	Discuss benefits and risks of high-intensity statins during medication review	Agree on any changes with the patient
Monitoring for Adverse Effects	Routinely monitor for muscle symptoms	Check CK if muscle symptoms are unexplained
Managing Adverse Effects	1. Stop...

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