Abstract
Background: Clinical practice guidelines support early detection and management of familial hypercholesterolaemia (FH) to prevent cardiovascular disease and improve survival. However, less than 10% of people thought to have FH have been detected in Australia. The aim of this study was to develop an implementation strategy for enhancing the detection of FH in Australia.
Methods: Eight FH Advisory Group meetings were conducted in each Australian state and territory using a purposive sample of stakeholders. The meetings were co-facilitated by a local clinical opinion leader and an implementation researcher for approximately two hours in 2022–2023. Transcripts were analysed using the Dynamic Adaptation Process.
Results: There were approximately 98 attendees across the eight meetings (range 7 to 16). We identified 14 models for diagnostic index case identification and six models for family cascade testing. Prominent models for index case detection were 1) pathology report alerts, 2) digital screening of electronic health record and pathology databases, 3) selective screening in coronary care units and cardiac rehabilitation, and 4) universal screening through the newborn bloodspot program. The main cascade testing models were 1) funded centralised coordination, 2) hospital-based coordination in collaboration with primary care, and 3) a direct patient and family augmented approach. The most common implementation strategies coded to the Expert Recommendations for Supporting Change taxonomy were 1) train and educate stakeholders and 2) engage consumers.
Conclusions: Future work will focus on implementing a primary-tertiary shared care model for FH genetic testing into routine clinical practice.
Methods: Eight FH Advisory Group meetings were conducted in each Australian state and territory using a purposive sample of stakeholders. The meetings were co-facilitated by a local clinical opinion leader and an implementation researcher for approximately two hours in 2022–2023. Transcripts were analysed using the Dynamic Adaptation Process.
Results: There were approximately 98 attendees across the eight meetings (range 7 to 16). We identified 14 models for diagnostic index case identification and six models for family cascade testing. Prominent models for index case detection were 1) pathology report alerts, 2) digital screening of electronic health record and pathology databases, 3) selective screening in coronary care units and cardiac rehabilitation, and 4) universal screening through the newborn bloodspot program. The main cascade testing models were 1) funded centralised coordination, 2) hospital-based coordination in collaboration with primary care, and 3) a direct patient and family augmented approach. The most common implementation strategies coded to the Expert Recommendations for Supporting Change taxonomy were 1) train and educate stakeholders and 2) engage consumers.
Conclusions: Future work will focus on implementing a primary-tertiary shared care model for FH genetic testing into routine clinical practice.
| Original language | English |
|---|---|
| Article number | 446 |
| Pages (from-to) | S314-S315 |
| Number of pages | 2 |
| Journal | Heart Lung and Circulation |
| Volume | 32 |
| Issue number | Supplement 3 |
| DOIs | |
| Publication status | Published - Jul 2023 |
| Event | 71st Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand - Adelaide, Australia Duration: 3 Aug 2023 → 6 Aug 2023 |