Advertisement

International Journal of Clinical Pharmacy

, Volume 34, Issue 4, pp 501–505 | Cite as

Detection and care of familial hypercholesterolaemia in the community: is there a role for the pharmacist?

  • Ines KrassEmail author
  • Adrian T. Walker
  • Gerald F. Watts
Commentary

Abstract

Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that causes marked elevation in plasma cholesterol and premature coronary heart disease. It is estimated that there are at 40 million people with FH worldwide, but most remain unrecognised and inadequately treated. To bridge this gap in coronary prevention several guidelines on detecting and managing FH have been published. We briefly review these and comment on the potential role of pharmacists in case detection, point-of-care testing and pharmacotherapy.

Keywords

Care models Cascade screening Familial hypercholesteroleamia Pharmacist role Screening 

Notes

Funding

None.

Conflicts of interest

None

References

  1. 1.
    Soutar AK, Naoumova RP. Mechanisms of disease: genetic causes of familial hypercholesterolemia. Nat Clin Pract Cardiovasc Med. 2007;4:214–25.PubMedCrossRefGoogle Scholar
  2. 2.
    Marks D, Thorogood M, Neil HAW, Humphries SE. A review on the diagnosis, natural history, and treatment of familial hypercholesterolaemia. Atherosclerosis. 2003;168:1–14.PubMedCrossRefGoogle Scholar
  3. 3.
    Versmissen J, Oosterveer DM, Yazdanpanah M, Defesche JC, Basart DCG, Liem AH, et al. Efficacy of statins in familial hypercholesterolaemia: a long term cohort study. Br Med J. 2008;337:a2423.CrossRefGoogle Scholar
  4. 4.
    Neil HAW, Hammond T, Huxley R, Matthews DR, Humphries SE. Extent of underdiagnosis of familial hypercholesterolaemia in routine practice: prospective registry study. Br Med J. 2000;321:148.CrossRefGoogle Scholar
  5. 5.
    National Institute for Health and Clinical Excellence, The National Collaborating Centre for Primary Care. NICE Clinical Guideline 71: Identification and management of familial hypercholesterolaemia. 2008 [cited 2011]; Available from: www.nice.org.uk/nicemedia/pdf/CG071NICEGuideline.pdf.
  6. 6.
    Civeira F. Guidelines for the diagnosis and management of heterozygous familial hypercholesterolaemia. Atherosclerosis. 2004;173:55–68.PubMedCrossRefGoogle Scholar
  7. 7.
    Goldberg AC, Hopkins PN, Toth PP, Ballantyne CM, Rader DJ, Robinson JG, et al. Familial hypercholesterolemia: screening, diagnosis and management of pediatric and adult patients: clinical guidance from the National Lipid Association Expert Panel on Familial hypercholesterolemia. J Clin Lipidol. 2011; 5:133–40.Google Scholar
  8. 8.
    The Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: summary report. Pediatrics. 2011; 28 Suppl 5:S213–S56.Google Scholar
  9. 9.
    Descamps OS, Tenoutasse S, Stephenne X, Gies I, Beauloye V, Lebrethon MC, et al. Management of familial hypercholesterolemia in children and young adults: Consensus paper developed by a panel of lipidologists, cardiologists, paediatricians, nutritionists, gastroenterologists, general practitioners and a patient organization. Atherosclerosis. 2011;218:272–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Watts GF, Sullivan DR, Poplawski N, van Bockxmeer F, Hamilton-Craig I, Clifton PM, et al. Familial hypercholesterolaemia: a model of care for Australasia. Atheroscler Suppl. 2011;12:221–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Reiner Ž, Catapano AL, De Backer G, Graham I, Taskinen M-R, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2011;32:1769–818.PubMedCrossRefGoogle Scholar
  12. 12.
    Robinson JG, Goldberg AC. Treatment of adults with Familial Hypercholesterolaemia and evidence for treatment: Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol. 2011;5(3 Suppl):S18–29.PubMedCrossRefGoogle Scholar
  13. 13.
    FDA Drug Safety Communication: Important safety label changes to cholesterol-lowering statin drugs. [cited 2012]; Available from: http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm.
  14. 14.
    Preiss D, Sattar N. Pharmacotherapy: statins and new-onset diabetes: the important questions. Nat Rev Cardiol. 2012;Advance online publication.Google Scholar
  15. 15.
    Daniels SR, Greer FR, Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122:198–208.PubMedCrossRefGoogle Scholar
  16. 16.
    Simoens S, Foulon E, Dethier M, Mathieu C, Laekeman G. Promoting targeted screening for type 2 diabetes mellitus: the contribution of community pharmacists. Diabet Med. 2005;22:812–3.PubMedCrossRefGoogle Scholar
  17. 17.
    Yamada C, Johnson JA, Robertson PP, Tsuyuki RT. Long-term impact of a community pharmacist intervention on cholesterol levels in patients at high risk for cardiovascular events: extended follow-up of the second study of cardiovascular risk intervention by pharmacists (SCRIP-plus). Pharmacotherapy. 2005;25:110–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Smith JD, Battye K, Roufeil L, Mitchell C, White C, Veitch C, et al. Research to track the rural pharmacy workforce and identify the role that rural programs have on retention of the rural pharmacy workforce. In: Ageing DoHa, editor, Pharmacy Guild of Australia; 2010.Google Scholar
  19. 19.
    Gerrald KR, Dixon DL, Barnette DJ, Williams VG. Evaluation of a pharmacist-managed lipid clinic that uses point-of-care lipid testing. J Clin Lipidol. 2010;4:120–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Bates TR, Connaughton VM, Watts GF. Non-adherence to statin therapy: a major challenge for preventive cardiology. Expert Opin Pharmacother. 2009;10:2973–85.PubMedCrossRefGoogle Scholar
  21. 21.
    Castelino RL, Bajorek BV, Chen TC. Are interventions recommended by pharmacists during home medicines review evidence-based? J Eval Clin Practi. 2010;17:104–10.CrossRefGoogle Scholar
  22. 22.
    Cottin SC, Saunders TA, Hall WL. The differential effects of EPA and DHA on cardiovascular risk factors. Proc Nutr Soc. 2011;70:215–31.PubMedCrossRefGoogle Scholar
  23. 23.
    Charrois TC, Zolezzi M, Koshman L, Pearson SL, Makowsky G, Durec M, et al. A systematic review of the evidence for pharmacist care of patients with dyslipidaemia. Pharmacotherapy. J Human Pharmacol Drug Therapy. 2012;32:222–33.Google Scholar
  24. 24.
    George J, McCaig DJ, Bond CM, Cunningham IS, Diack HL, Watson AM, Stewart DC. Supplementary prescribing: early experiences of pharmacists in Great Britain. Ann Pharmacotherapy. 2006;40:1843–50.CrossRefGoogle Scholar
  25. 25.
    Block R, Pearson T. Organizing services for cardiovascular prevention. Curr Treat Options Cardiovasc Med. 2007;9:278–86.PubMedCrossRefGoogle Scholar
  26. 26.
    Pedersen KMV, Humphries SE, Roughton M, Besford JS. The National Audit of the Management of Familial Hypercholesterolaemia 2010: Full report. [cited; Available from: www.rcplondon.ac.uk/node/2584.

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Ines Krass
    • 1
    Email author
  • Adrian T. Walker
    • 2
  • Gerald F. Watts
    • 3
  1. 1.Faulty of Pharmacy A15University of SydneyCamperdownAustralia
  2. 2.Combined Universities Centre for Rural HealthCurtin UniversityGeraldtonAustralia
  3. 3.Lipid Disorders Clinic, Metabolic Research Centre and Department of Internal Medicine, School of Medicine and Pharmacology, Royal Perth Hospital UnitThe University of Western Australia (M570)CrawleyAustralia

Personalised recommendations