How Can Implementation Science Improve the Care of Familial Hypercholesterolaemia?

Mitchell Sarkies, Laney K Jones, Jing Pang, David Sullivan, Gerald F Watts

Journal: Current atherosclerosis reports 2023;25(4):133-143

PMID: 36806760

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Abstract

PURPOSE OF REVIEW

Describe the application of implementation science to improve the detection and management of familial hypercholesterolaemia.

RECENT FINDINGS

Gaps between evidence and practice, such as underutilization of genetic testing, family cascade testing, failure to achieve LDL-cholesterol goals and low levels of knowledge and awareness, have been identified through clinical registry analyses and clinician surveys. Implementation science theories, models and frameworks have been applied to assess barriers and enablers in the literature specific to local contextual factors (e.g. stages of life). The effect of implementation strategies to overcome these factors has been evaluated; for example, automated identification of individuals with FH or training and education to improve statin adherence. Clinical registries were identified as a key infrastructure to monitor, evaluate and sustain improvements in care. The expansion in evidence supporting the care of familial hypercholesterolaemia requires a similar expansion of efforts to translate new knowledge into clinical practice.

Address: School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia. [email protected].; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia. [email protected].; Department of Genomic Health, Research Institute, Geisinger, Danville, PA, USA.; Heart and Vascular Institute, Geisinger, Danville, PA, USA.; School of Medicine, University of Western Australia, Perth, WA, Australia.; Department of Chemical Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.; Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.

DOI: 10.1007/s11883-023-01090-6