TY - JOUR
T1 - Familial hypercholesterolaemia: A model of care for Australasia
AU - Watts, Gerald
AU - Sullivan, David
AU - Poplawski, Nicola
AU - van Bockxmeer, Frank
AU - Hamilton-Craig, Ian
AU - Clifton, Peter
AU - O'Brien, Richard
AU - Bishop, Warrick
AU - George, Peter
AU - Barter, P
AU - Bates, Timothy
AU - Burnett, John
AU - Coakley, John
AU - Davidson, Patricia
AU - Emery, Jon
AU - Martin, Andrew
AU - Farid, Waleed
AU - Freeman, Lucinda
AU - Geelhoed, Elizabeth
AU - Juniper, Amanda
AU - Kidd, Alexa
AU - Kostner, Karam
AU - Krass, Ines
AU - Livingston, Michael
AU - Maxwell, Suzy
AU - O'Leary, Peter
AU - Owaimrin, Amal
AU - Redgrave, Trevor
AU - Reid, Nicola
AU - Southwell, Lynda
AU - Suthers, Graeme
AU - Tonkin, Andrew
AU - Towler, Simon
AU - Trent, Ronald
PY - 2011/10
Y1 - 2011/10
N2 - Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that causes marked elevation in plasma cholesterol and premature coronary heart disease. There are at least 45,000 people with FH in Australia and New Zealand, but the vast majority remains undetected and those diagnosed with the condition are inadequately treated.To bridge this major gap in coronary prevention the FH Australasia Network (Australian Atherosclerosis Society) has developed a consensus model of care (MoC) for FH. The MoC is based on clinical experience, expert opinion, published evidence and consultations with a wide spectrum of stakeholders, and has been developed for use primarily by specialist centres intending starting a clinical service for FH. This MoC aims to provide a standardised, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes.The MoC for FH is presented as a series of recommendations and algorithms focusing on the standards required for the detection, diagnosis, assessment and management of FH in adults and children. The process involved in cascade screening and risk notification, the backbone for detecting new cases of FH, is detailed. Guidance on treatment is based on risk stratifying patients, management of non-cholesterol risk factors, safe and effective use of statins, and a rational approach to follow-up of patients. Clinical and laboratory recommendations are given for genetic testing. An integrative system for providing best clinical care is described.This MoC for FH is not prescriptive and needs to be complemented by good clinical judgment and adjusted for local needs and resources. After initial implementation, the MoC will require critical evaluation, development and appropriate modification.
AB - Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that causes marked elevation in plasma cholesterol and premature coronary heart disease. There are at least 45,000 people with FH in Australia and New Zealand, but the vast majority remains undetected and those diagnosed with the condition are inadequately treated.To bridge this major gap in coronary prevention the FH Australasia Network (Australian Atherosclerosis Society) has developed a consensus model of care (MoC) for FH. The MoC is based on clinical experience, expert opinion, published evidence and consultations with a wide spectrum of stakeholders, and has been developed for use primarily by specialist centres intending starting a clinical service for FH. This MoC aims to provide a standardised, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes.The MoC for FH is presented as a series of recommendations and algorithms focusing on the standards required for the detection, diagnosis, assessment and management of FH in adults and children. The process involved in cascade screening and risk notification, the backbone for detecting new cases of FH, is detailed. Guidance on treatment is based on risk stratifying patients, management of non-cholesterol risk factors, safe and effective use of statins, and a rational approach to follow-up of patients. Clinical and laboratory recommendations are given for genetic testing. An integrative system for providing best clinical care is described.This MoC for FH is not prescriptive and needs to be complemented by good clinical judgment and adjusted for local needs and resources. After initial implementation, the MoC will require critical evaluation, development and appropriate modification.
KW - Adolescents
KW - Adults
KW - Assessment
KW - Cascade screening
KW - Children
KW - Diagnosis
KW - Familial hypercholesterolaemia
KW - Genetic testing
KW - Model of care
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84855501197&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosissup.2011.06.001
DO - 10.1016/j.atherosclerosissup.2011.06.001
M3 - Article
VL - 12
SP - 221
EP - 263
JO - Atherosclerosis Supplements
JF - Atherosclerosis Supplements
SN - 1567-5688
IS - 2
ER -