Department of Internal Medicine, Division of Cardiovascular Genetics, University of Utah School of Medicine, 420 Chipeta Way, Room 1160, Salt Lake City, Utah 84108 USA.
J Clin Lipidol. 2009 Apr;3(2):94-100. doi: 10.1016/j.jacl.2009.02.004. Epub 2009 Feb 11.
Patients with heterozygous familial hypercholesterolemia (FH) patients often have difficultly achieving National Cholesterol Education Program (NCEP) goals. Herein we present an evaluation of a centrally located, nationwide treatment support program that remotely attempted to educate and guide FH patients by monitoring their serum low-density lipoprotein (LDL) cholesterol levels and giving appropriate treatment recommendations through mail contact. All subjects were FH patients registered with the Make Early Diagnosis to Prevent Early Deaths (MEDPED) program.
In this descriptive evaluation, we compared self-reported lipid levels in 386 FH patients participating in our treatment support program with 295 non-participants who had responded to questionnaires. Participants were recruited into the treatment support program if they had not reached their LDL cholesterol goal after at least 1 year of follow-up and were unable to receive specialized lipid care due to location.
Participants who continued for a longer term in the treatment support program achieved greater total cholesterol reductions (14%) than the comparison group (7%, P=.004). Reductions in total and LDL cholesterol were highly correlated with more aggressive use of statin medications (P <.0001).
These results demonstrate the potential benefits and limitations of a centralized program operating remotely to encourage appropriate treatment of severe hypercholesterolemia.
杂合子家族性高胆固醇血症（FH）患者常常难以达到国家胆固醇教育计划（NCEP）的目标。在此，我们评估了一个集中式的全国性治疗支持计划，该计划通过监测患者的血清低密度脂蛋白（LDL）胆固醇水平并通过邮件联系提供适当的治疗建议，远程尝试教育和指导 FH 患者。所有受试者均为参加 Make Early Diagnosis to Prevent Early Deaths（MEDPED）计划的 FH 患者。
在这项描述性评估中，我们将参与我们治疗支持计划的 386 名 FH 患者的自我报告的血脂水平与 295 名通过问卷回复的非参与者进行了比较。如果参与者在至少 1 年的随访后仍未达到 LDL 胆固醇目标，并且由于地理位置无法接受专门的血脂护理，则将其招募到治疗支持计划中。
在治疗支持计划中持续时间更长的参与者实现了更大的总胆固醇降低（14%），而对照组为 7%（P=.004）。总胆固醇和 LDL 胆固醇的降低与更积极地使用他汀类药物高度相关（P<.0001）。
这些结果表明，远程集中式计划鼓励适当治疗严重高胆固醇血症具有潜在的益处和局限性。
