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.
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Heart Lung Circ. 2023 Nov;32(11):1347-1353. doi: 10.1016/j.hlc.2023.09.012. Epub 2023 Oct 19.
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.
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.
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.
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.
家族性高胆固醇血症（FH）是一种遗传性疾病，可导致过早发生心血管疾病发病率和死亡率。高水平的证据和临床实践指南支持对 FH 患者进行预防保健。然而，据估计，在澳大利亚的卫生机构中，使用任何方法检测到 FH 风险的人群不到 10%。本研究旨在确定在澳大利亚检测 FH 的实施障碍和促进因素。
作为 2021 年澳大拉西亚 FH 峰会的一部分，实施科学家和临床医生主持了四次为期 2 小时的虚拟焦点小组。使用模板分析来确定主题。
在四个小组（每组 6-8 人）中共有 28 名与会者，共确定了三个主题的 13 个障碍和 10 个促进因素：（1）患者相关，（2）提供者相关，和（3）系统相关。“缺乏护理途径”和“提高临床医生识别和诊断 FH 的能力”是 FH 检测最相关的障碍和促进因素。
患者、提供者和系统主题之间的障碍和促进因素之间的关系表明，需要制定综合实施策略来解决这些不同层面的问题。正在进行进一步的研究，以制定将澳大利亚 FH 指南付诸实践的模型。
