@article { , title = {Improving identification \& management of familial hypercholesterolaemia in primary care: pre- and post-intervention study}, abstract = {Background and Aims: 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. Methods: 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. Results: 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 prescribing 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). Conclusions: Within 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.}, doi = {10.1016/j.atherosclerosis.2018.04.037}, eissn = {0021-9150}, issn = {0021-9150}, journal = {Atherosclerosis}, note = {Gold Open Access. KJH 01.05.2018. Updated OL. 11.05.2018}, pages = {54-60}, publicationstatus = {Published}, publisher = {Elsevier}, url = {https://nottingham-repository.worktribe.com/output/948572}, volume = {274}, keyword = {Primary health care, Familial hypercholesterolaemia, Family health, Medical genetics.}, year = {2018}, author = {Weng, Stephen and Kai, Joe and Tranter, Jennifer and Leonardi-Bee, Jo and Qureshi, Nadeem} }