Sarkies, Mitchell N

Testa, Luke

Best, Stephanie

Moullin, Joanna C

Sullivan, David

Bishop, Warrick

Kostner, Karam

Clifton, Peter

Hare, David

Brett, Tom

Hutchinson, Karen

Black, Andrew

Braithwaite, Jeffrey

Nicholls, Stephen J

Kangaharan, Nadarajah

Pang, Jing

Abhayaratna, Walter

Horton, Ari

Watts, Gerald F

2023-11-01

BACKGROUND: Familial hypercholesterolaemia (FH) is a genetic condition that is a preventable cause of premature cardiovascular morbidity and mortality. High-level evidence and clinical practice guidelines support preventative care for people with FH. However, it is estimated that less than 10% of people at risk of FH have been detected using any approach across Australian health settings. The aim of this study was to identify the implementation barriers to and facilitators of the detection of FH in Australia. METHODS: Four, 2-hour virtual focus groups were facilitated by implementation scientists and a clinicians as part of the 2021 Australasian FH Summit. Template analysis was used to identify themes. RESULTS: There were 28 workshop attendees across four groups (n=6-8 each), yielding 13 barriers and 10 facilitators across three themes: (1) patient related, (2) provider related, and (3) system related. A "lack of care pathways" and "upskilling clinicians in identifying and diagnosing FH" were the most interconnected barriers and facilitators for the detection of FH. CONCLUSIONS: The relationships between barriers and facilitators across the patient, provider, and system themes indicates that a comprehensive implementation strategy is needed to address these different levels. Future research is underway to develop a model for implementing the Australian FH guidelines into practice.

School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia. Electronic address: mitchell.sarkies@sydney.edu.au.

Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.

Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Vic, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic, Australia.

School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.

Department of Chemical Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Department of Cardiology, Calvary Cardiac Centre, Calvary Health Care, Hobart, Tas, Australia.

Department of Cardiology, Mater Hospital, University of Queensland, Brisbane, Qld, Australia.

Department of Endocrinology, Royal Adelaide Hospital, Adelaide, SA, Australia.

Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.

General Practice and Primary Health Care Research, School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.

Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia.

Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Vic, Australia.

Department of Cardiology, Royal Darwin Hospital, Darwin, NT, Australia.

School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia.

College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.

Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Vic, Australia; Monash Heart and Monash Children's Hospital, Monash Health, Melbourne, Vic, Australia; Monash Genetics, Monash Health, Melbourne, Vic, Australia; Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Vic, Australia; Department of Paediatrics, Monash University Clayton, Vic, Australia.

School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.

Heart Lung Circ. 2023 Nov;32(11):1347-1353. doi: 10.1016/j.hlc.2023.09.012. Epub 2023 Oct 19.

https://pubmed.ncbi.nlm.nih.gov/37865587/?otool=iaurydwlib

https://hdl.handle.net/10137/12601

32

Humans

Australia/epidemiology

*Hyperlipoproteinemia Type II/diagnosis/genetics/therapy

Disease Progression

Mass Screening

Barriers to and Facilitators of Implementing Guidelines for Detecting Familial Hypercholesterolaemia in Australia.

Journal Article

Publication