Improving identification and management of familial hypercholesterolaemia in primary care: Pre- and post-intervention study

Atherosclerosis
Stephen WengNadeem Qureshi

Abstract

Familial hypercholesterolaemia (FH) is a major cause of premature heart disease but remains unrecognised in most patients. This study investigated if a systematic primary care-based approach to identify and manage possible FH improves recommended best clinical practice. Pre- and post-intervention study in six UK general practices (population 45,033), which invited patients with total cholesterol >7.5 mmol/L to be assessed for possible FH. Compliance with national guideline recommendations to identify and manage possible FH (repeat cholesterol; assess family history of heart disease; identify secondary causes and clinical features; reduce total & LDL-cholesterol; statin prescribing; lifestyle advice) was assessed by calculating the absolute difference in measures of care pre- and six months post-intervention. The intervention improved best clinical practice in 118 patients consenting to assessment (of 831 eligible patients): repeat cholesterol test (+75.4%, 95% CI 66.9-82.3); family history of heart disease assessed (+35.6%, 95% CI 27.0-44.2); diagnosis of secondary causes (+7.7%, 95% CI 4.1-13.9), examining clinical features (+6.0%, 95% CI 2.9-11.7). For 32 patients diagnosed with possible FH using Simon-Broome criteria, statin...Continue Reading

Citations

Nov 8, 2019·The Cochrane Database of Systematic Reviews·Alpo VuorioUma Ramaswami
May 1, 2021·Journal of Personalized Medicine·Luisa SilvaJo Leonardi-Bee
Oct 8, 2021·The Cochrane Database of Systematic Reviews·Nadeem QureshiJo Leonardi-Bee
Dec 7, 2021·The Journal of Clinical Endocrinology and Metabolism·Wael E EidCarl Miller

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