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Developing a national implementation strategy for enhancing the detection of familial hypercholesterolemia: An Australian experience

Resource type
Authors/contributors
Title
Developing a national implementation strategy for enhancing the detection of familial hypercholesterolemia: An Australian experience
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is a common and treatable inherited condition of cholesterol metabolism that increases cardiovascular health risk. Less than 10% of people with FH have been detected and few receive recommended treatment. OBJECTIVE We report on the development of a national implementation strategy for enhancing the detection of FH in Australia. METHODS A modified intervention mapping study was conducted, through workshops to identify barriers and facilitators of FH detection, models for detection and their objectives. Practical implementation strategies were selected using a constructivist analysis and summaries of the strategies were disseminated for feedback. A case study showcase was used to monitor strategy implementation. RESULTS Potential models for FH detection were identified, including (1) use of pathology lab reports and recall; (2) screening in general practice, pharmacy, and Aboriginal Community Controlled Health Organizations; (3) screening in cardiovascular inpatients, outpatients, and rehabilitation; (4) universal screening; and (5) centralized coordination of primary-tertiary shared care. Implementation strategies were selected for each model to support their operationalization into routine care. A list of general implementation strategies was also produced that could support multiple models for FH detection. CONCLUSION We identified multiple FH detection models and strategies that would support implementation across Australia. Centralized coordination of a primary-tertiary shared care model was described as a promising approach for integrating index case detection with family cascade testing. We provide a set of implementation recommendations for policy and practice to enhance the detection of FH in Australia.
Publication
Journal of Clinical Lipidology
Date
05/2025
Volume
19
Issue
3
Pages
582-594
Journal Abbr
Journal of Clinical Lipidology
Accessed
7/7/25, 2:16 AM
ISSN
19332874
Short Title
Developing a national implementation strategy for enhancing the detection of familial hypercholesterolemia
Language
en
Library Catalog
DOI.org (Crossref)
Notes

Study topic:
Design and development of a national strategy to improve detection of familial hypercholesterolemia (FH) across Australian healthcare settings.

Study type:
Modified intervention mapping study

Key findings:

  • HealthPathways was used to embed FH screening and data extraction tools into general practice workflows, supporting implementation at the point of care.
  • The strategy identified five models for FH detection and matched them with tailored implementation strategies, including integration into primary care, pathology alerts, and hospital-based screening.
  • Centralized coordination of shared care between primary and tertiary services was highlighted as a sustainable model for integrating index case detection with family cascade testing.
  • Implementation recommendations included standardizing pathology alerts, embedding FH prompts in general practice software, and leveraging existing funding mechanisms such as the Medicare Benefits Schedule.
  • The strategy emphasized the importance of adapting tools and messaging to local contexts, including rural outreach and telehealth, aligning with HealthPathways’ principles of localized, evidence-informed care.
Citation
Sarkies, M., Sullivan, D., Black, A., Aylward, P., Kostner, K., Nicholls, S. J., Horton, A., Abhayaratna, W. P., Kangaharan, N., Pang, J., Bishop, W., Elias, L., Srinivasan, S., Waddell-Smith, K. E., Della-Vedova, J., Hespe, C., Tiller, J., Braithwaite, J., Birkenhead, K., & Watts, G. F. (2025). Developing a national implementation strategy for enhancing the detection of familial hypercholesterolemia: An Australian experience. Journal of Clinical Lipidology, 19(3), 582–594. https://doi.org/10.1016/j.jacl.2025.03.004