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• W2802451775 abstract "Background and aimsFamilial 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.MethodsPre- 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.ResultsThe 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 prescription significantly improved (18.8%, 95% CI 8.9–35.3), with non-significant mean reductions in cholesterol post-intervention (total: −0.16 mmol/L, 95% CI -0.78-0.46; LDL: −0.12 mmol/L, 95% CI -0.81-0.57).ConclusionsWithin six months, this simple primary care intervention improved both identification and management of patients with possible FH, in line with national evidence-based guidelines. Replicating and sustaining this approach across the country could lead to substantial improvement in health outcomes for these individuals with very high cardiovascular risk." @default.
• W2802451775 created "2018-05-17" @default.
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• W2802451775 date "2018-07-01" @default.
• W2802451775 modified "2023-09-27" @default.
• W2802451775 title "Improving identification and management of familial hypercholesterolaemia in primary care: Pre- and post-intervention study" @default.
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• W2802451775 doi "https://doi.org/10.1016/j.atherosclerosis.2018.04.037" @default.
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