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Evaluation of lipid services in the Republic of Ireland

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Abnormal cholesterol profiles are a major risk factor for cardiovascular disease and severe triglyceride disorders cause life threatening pancreatitis. Identification and treatment of these disorders are essential.

Aim

We evaluated the services available in Ireland to manage these problems.

Methods

We contacted key personnel in 40 hospitals, 32 public and 8 private providing lipid measurements to assess investigation and treatment availability during 2017/2018.

Results

In public hospitals, 4 had designated lipid clinics (Dublin 3, Galway 1) (2.9 times < UK), 19 had general clinics and 9 had no service. In private hospitals, 2 had designated clinics, Limerick and Cork, and others had interested physicians. Clinics were run by cardiologists, chemical pathologists, endocrinologists or clinical pharmacologists. One clinic had a lipid nurse versus 75% in the UK. All but one provided full lipid profiles, 15 ordered Lp(a), 9 apoproteins B/A-1 and 9 genetic testing. Lp(a) and apoprotein measurements were provided locally in one hospital and one provided genetic testing. Lipid-lowering drugs were used in all hospitals and 45% had access to PCSK-9 inhibitors. No hospital provided LDL apheresis or plasma exchange. Limitations for service provision included lack of physician interest n = 9, nursing support n = 22, office space n = 13, clinic space n = 22, laboratory support n = 16, nutritional support n = 12 and pharmacy support n = 5.

Conclusions

There are very limited resources available to manage lipid problems in the republic of Ireland relative to the under-resourced UK. Most services rely on interested physicians but ancillary resources are lacking. Where services are available, all drug treatments are utilised.

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Acknowledgements

The authors would like to thank all those consultants and laboratory personnel who completed the questionnaires or participated in interviews to provide the data regarding the lipid services available in their respective hospitals.

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Authors and Affiliations

  1. Advanced Lipid Management And Research (ALMAR) Centre, Division of Cardiology, Department of Medicine, Tallaght University Hospital, Tallaght, D24, Ireland

    Ruth Agar, Meabh Prendergast & Vincent Maher

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  1. Ruth Agar
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  2. Meabh Prendergast
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  3. Vincent Maher
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Correspondence to Vincent Maher.

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The authors declare that they have no conflict of interest.

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This study was deemed to be a service evaluation, as assessed by Trinity College Ethics Committee Chairperson, and did not require ethical approval.

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Appendix

Appendix

Questionnaire evaluating hospital lipid services

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Agar, R., Prendergast, M. & Maher, V. Evaluation of lipid services in the Republic of Ireland. Ir J Med Sci 189, 925–931 (2020). https://doi.org/10.1007/s11845-020-02187-6

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