Omega-3-Acid Ethyl EstersAudit Template

This template can be used to document the Omega-3-acid ethyl estersaudit undertaken by practices as part of the Incentive Scheme.

It has been produced to provide practices with a guide but may be adapted to suit the needs of the practice or individual audit.

Practice Name
Audit Undertaken By and Job Title
Date of Audit
Aim / To review and if appropriate revise prescribing of omega-3-acid ethylesters in line with NICE guidance (CG 48, MI secondary prevention and CG87, type 2 diabetes)
Background (Reason for audit being undertaken) / NICE Clinical Guideline 48 (MI, secondary prevention) contains a recommendation that, post MI, patients should be encouraged to consume at least 7g of omega 3 fatty acids per week, from 2 to 4 portions of oily fish. Patients not achieving this should be considered for at least 1g daily of Omega-3-acid ethyl esters for up to 4 years post MI.
NICE Clinical Guideline 87 (Type 2 diabetes) states that fish oil preparations should not be prescribed for the primary prevention of cardiovascular disease in people with type 2 diabetes. This recommendation does not apply to people with hypertriglyceridaemia receiving advice from a healthcare professional with special expertise in blood lipid management. A trial of highly concentrated, licensed omega-3 fish oils for refractory hypertriglyceridaemia should only be considered if lifestyle measures and fibrate therapy have failed.
Audit Criteria/Audit Standard / For the secondary prevention of MI, if patients are not managing to consume 7g of omega-3 fatty acids per week (from 2-4 portions of oily fish) then patients should be considered for omega-3 ethyl esters therapy. If required, this should be started within 3 months of an MI and therapy ceased after 4 years post MI.
For hypertriglceridaemia, patients should be assessed to ensure therapy for an appropriate indication and recommended by specialist.
Audit Period (if different to audit date) / 3 months retrospective data
Description of Method / Search all patients taking omega-3-acid ethyl esters (A).
Patients taking omega-3-acid ethyl esters for secondary prevention of MI (B)
Patients taking omega-3-acid ethyl esters for any other indication (C)
Patients in group B that are in line with NICE (D)
Patients in group C that are in line with NICE CG 87 or being prescribed on the basis of specialist advice (E)
Results / D/B x 100 = ……% of patients in line with NICE CG 48
E/C x 100 = …….% patients in line with NICE CG 87
Action Plan (including timescales and need to re-audit)
Prescribing incentive scheme audit template: Omega-3-acid ethyl esters
Wirral Medicines Management Team
Version 0.4 / Page 1 of 3
June 2013

Omega-3-Acid EthylEsters Prescribing Audit Data Collection Sheet

(Practices may find it simpler to consider MI patients separately from other patients taking omega-3-acid ethyl esters.)

Patient ID / Omega-3-acid ethyl esters dose and date started / Indication
(A) Adjunct in secondary prevention in those who have had an MI
(B) Adjunct to diet and statin in hypertriglyceridaemia
(C) Other, please specify / Omega-3-acid ethyl esters initiated in primary, secondary or tertiary care? Please specify / If post MI, had dietary omega-3 fatty acids been encouraged first and for how long? / Omega-3-acid ethyl esters initiated within 3 months post MI? / If post-MI, is the correct “one daily” dose used? / Omega-3-acid ethyl-esters ceased 4 years post MI? / Omega-3-acid-ethyl-esters prescription appropriate for MI as per NICE CG48? / If for hypertriglceridaemia in type 2 diabetes, has CG 87 been followed or on the basis of specialist advice? / If for any other indication, is this on the basis of specialist advice and why? Was recommendation to prescribe challenged if not within licensed indications?

Audited by:………………………………………………. Date audit started…………………………

Prescribing incentive scheme audit template: Omega-3-acid ethyl esters
Wirral Medicines Management Team
Version 0.4 / Page 1 of 3
June 2013

Summary of Findings – Omega-3-Acid Ethyl Esters Audit

Audit title / Omega-3-acid ethyl esters audit
Number of patients on search taking omega-3-acid ethyl esters (A)
Number of patients taking omega-3-acid ethyl esters for secondary prevention of MI (B)
Number of patients taking omega-3-acid ethyl esters for any other indication (C)
Number of patients in group B that are in line with NICE CG48 (D)
D/B x 100 = ……%
Number of patients in group C that are in line with NICE CG87 or being prescribed on the basis of specialist advice (E)
E/C x 100 = …….%
Action(s) still needed or re-audit date.
If omega-3-acid ethyl ester prescribing not meeting NICE guidelines or appropriate specialist recommendations then an action plan should be drawn up to address this and then re-audit completed.

Practice name ……………………………………… Date of audit ………………

References Sources

1)NICE Clinical Guideline 48, May 2007. MI: Secondary Prevention. Accessed via <28.4.2013>

2)NICE Clinical Guideline 87, May 2009. Type 2 diabetes. The management of type 2 diabetes. Accessed via

Prescribing incentive scheme audit template: Omega-3-acid ethyl esters
Wirral Medicines Management Team
Version 0.4 / Page 1 of 3
June 2013