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HEART UK Medway report underlines importance of GP testing to identify inherited high cholesterol
By: HEART UK
The HEART UK report, launched during National Cholesterol Month, focused on a pilot project in Medway, where GPs created an audit prompt which helped them to identify those patients who have higher cholesterol which may be associated with conditions such as Familial Hypercholesterolaemia (FH).
A dedicated nurse was also introduced to review patients found using the audit prompt, resulting in greater numbers of patients being identified and therefore saving lives.
HEART UK Chief Executive, Ms Jules Payne, said: “This proves without doubt that primary care can do a great deal more to identify cases of inherited high cholesterol. GP practices are an obvious place to find FH cases, but GPs are very busy so they need some help to do this.
“People with FH are born with a higher cholesterol than normal, which can lead to early death as young as in their 20s, and in complicated cases in teenage years.
“Unlike most genetic conditions, FH is treatable and once identified and treated, patients should be able to live a normal long life: but early diagnosis is essential. There are more than 100,000 undiagnosed ticking time bombs with the condition in the UK. We need to avoid the tragedy of families losing loved ones prematurely.”
The Medway pilot scheme, which ran from 2011-2014, involved a trigger being put on GP practice systems which identified patients that fit criteria as possible FH cases. The prompt sits within BMJ’s Audit+ software, which can provide prompts to clinicians when patients are seen and produce lists of patients at a practice level who may benefit from screening.
This increased potential cases from one in 750 (346 people in Medway) to one in 357 (728 people), but it still left a high number of unscreened potential FH cases. HEART UK put a dedicated nurse into Medway’s participating GP practices, who worked her way through the possible cases identified by the trigger, increasing the prevalence significantly.
Dr Peter Green, Chief Clinical Officer, Medway CCG, who developed the pilot project, said: “Over a short period of time, we identified a far greater number of patients with FH. This was achieved by making it easier for practices to find patients at risk.
“I agree with HEART UK’s conclusions that our study shows that by equipping GP practices with the right tools to make it easier to find cases of FH more patients will be diagnosed and treated.”
Professor Huon Gray, National Clinical Director for Heart Disease, NHS England, said: “One of the key priorities of the Cardiovascular Disease Outcomes Strategy is to identify and treat more cases of FH. Through this project, significant inroads have now been made in Medway. I would encourage other CCGs to study its methods and outcomes.”
This pilot project was supported by a grant from Sanofi and the report can be read here: http://www.heartuk.org.uk
People wishing to find out more about raised cholesterol and associated conditions should contact: HEART UK on their helpline – 0345 450 5988, or visit http://www.heartuk.org.uk