Comparative aspects of the care of familial hypercholesterolemia in the “Ten Countries Study”
Background: There is a lack of information on the health care of familial hypercholesterolemia (FH). Objective: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere. Methods: A series of questionnaires were completed by key...
Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
Elsevier Ltd
2019
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Subjects: | |
Online Access: | View Fulltext in Publisher View in Scopus |
LEADER | 05784nam a2201189Ia 4500 | ||
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001 | 10.1016-j.jacl.2019.01.009 | ||
008 | 220121s2019 CNT 000 0 und d | ||
020 | |a 19332874 (ISSN) | ||
245 | 1 | 0 | |a Comparative aspects of the care of familial hypercholesterolemia in the “Ten Countries Study” |
260 | 0 | |b Elsevier Ltd |c 2019 | |
650 | 0 | 4 | |a apheresis |
650 | 0 | 4 | |a Article |
650 | 0 | 4 | |a Asia-pacific region |
650 | 0 | 4 | |a Australia |
650 | 0 | 4 | |a blood |
650 | 0 | 4 | |a Blood Component Removal |
650 | 0 | 4 | |a Brazil |
650 | 0 | 4 | |a cardiovascular disease |
650 | 0 | 4 | |a Cardiovascular Diseases |
650 | 0 | 4 | |a China |
650 | 0 | 4 | |a Cholesterol, LDL |
650 | 0 | 4 | |a comparative study |
650 | 0 | 4 | |a complication |
650 | 0 | 4 | |a cost effectiveness analysis |
650 | 0 | 4 | |a Delivery of Health Care |
650 | 0 | 4 | |a diet therapy |
650 | 0 | 4 | |a Diet Therapy |
650 | 0 | 4 | |a economics |
650 | 0 | 4 | |a ezetimibe |
650 | 0 | 4 | |a Facilities |
650 | 0 | 4 | |a familial hypercholesterolemia |
650 | 0 | 4 | |a Familial hypercholesterolemia |
650 | 0 | 4 | |a genetic screening |
650 | 0 | 4 | |a Health care |
650 | 0 | 4 | |a health care cost |
650 | 0 | 4 | |a Health Care Costs |
650 | 0 | 4 | |a health care delivery |
650 | 0 | 4 | |a health education |
650 | 0 | 4 | |a Health Education |
650 | 0 | 4 | |a Hong Kong |
650 | 0 | 4 | |a human |
650 | 0 | 4 | |a Humans |
650 | 0 | 4 | |a Hyperlipoproteinemia Type II |
650 | 0 | 4 | |a Insurance, Health, Reimbursement |
650 | 0 | 4 | |a international cooperation |
650 | 0 | 4 | |a Internationality |
650 | 0 | 4 | |a Japan |
650 | 0 | 4 | |a lipoprotein apheresis |
650 | 0 | 4 | |a low density lipoprotein cholesterol |
650 | 0 | 4 | |a Malaysia |
650 | 0 | 4 | |a medical specialist |
650 | 0 | 4 | |a New Zealand |
650 | 0 | 4 | |a nicotinic acid |
650 | 0 | 4 | |a non invasive procedure |
650 | 0 | 4 | |a PCSK9 protein, human |
650 | 0 | 4 | |a Philippines |
650 | 0 | 4 | |a priority journal |
650 | 0 | 4 | |a probucol |
650 | 0 | 4 | |a proprotein convertase 9 |
650 | 0 | 4 | |a Proprotein Convertase 9 |
650 | 0 | 4 | |a public expenditure |
650 | 0 | 4 | |a questionnaire |
650 | 0 | 4 | |a register |
650 | 0 | 4 | |a Registries |
650 | 0 | 4 | |a reimbursement |
650 | 0 | 4 | |a resin |
650 | 0 | 4 | |a risk assessment |
650 | 0 | 4 | |a Risk Assessment |
650 | 0 | 4 | |a screening test |
650 | 0 | 4 | |a serine proteinase inhibitor |
650 | 0 | 4 | |a Serine Proteinase Inhibitors |
650 | 0 | 4 | |a Services |
650 | 0 | 4 | |a South Africa |
650 | 0 | 4 | |a Southern hemisphere |
650 | 0 | 4 | |a Taiwan |
650 | 0 | 4 | |a United Kingdom |
650 | 0 | 4 | |a Viet Nam |
856 | |z View Fulltext in Publisher |u https://doi.org/10.1016/j.jacl.2019.01.009 | ||
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520 | 3 | |a Background: There is a lack of information on the health care of familial hypercholesterolemia (FH). Objective: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere. Methods: A series of questionnaires were completed by key opinion leaders from selected specialist centers in 12 countries concerning aspects of the care of FH, including screening, diagnosis, risk assessment, treatment, teaching/training, and research; the United Kingdom (UK)was used as the international benchmark. Results: The estimated percentage of patients diagnosed with the condition was low (overall <3%)in all countries, compared with ∼15% in the UK. Underdetection of FH was associated with government expenditure on health care (ϰ = 0.667, P <.05). Opportunistic and systematic screening methods, and the Dutch Lipid Clinic Network criteria were most commonly used to detect FH; genetic testing was infrequently used. Noninvasive imaging of coronary calcium and/or carotid plaques was underutilized in risk assessment. Patients with FH were generally not adequately treated, with <30% of patients achieving guideline recommended low-density lipoprotein cholesterol targets on conventional therapies. Treatment gaps included suboptimal availability and use of lipoprotein apheresis and proprotein convertase subtilsin-kexin type 9 inhibitors. A deficit of FH registries, training programs, and publications were identified in less economically developed countries. The demonstration of cost-effectiveness for cascade screening, genetic testing, and specialized treatments were significantly associated with the availability of subsidies from the health care system (ϰ = 0.571–0.800, P <.05). Conclusion: We identified important gaps across the continuum of care for FH, particularly in less economically developed countries. Wider implementation of primary and pediatric care, telehealth services, patient support groups, education/training programs, research activities, and health technology assessments are needed to improve the care of patients with FH in these countries. © 2019 National Lipid Association | |
700 | 1 | 0 | |a Ademi, Z. |e author |
700 | 1 | 0 | |a Chan, D.C. |e author |
700 | 1 | 0 | |a Charng, M.-J. |e author |
700 | 1 | 0 | |a Florkowski, C.M. |e author |
700 | 1 | 0 | |a George, P.M. |e author |
700 | 1 | 0 | |a Gonzalez-Santos, L.E. |e author |
700 | 1 | 0 | |a Hu, M. |e author |
700 | 1 | 0 | |a Kwok, S. |e author |
700 | 1 | 0 | |a Lin, J. |e author |
700 | 1 | 0 | |a Loi, D.D. |e author |
700 | 1 | 0 | |a Marais, A.D. |e author |
700 | 1 | 0 | |a Muir, L.A. |e author |
700 | 1 | 0 | |a Nawawi, H.M. |e author |
700 | 1 | 0 | |a Pang, J. |e author |
700 | 1 | 0 | |a Santos, R.D. |e author |
700 | 1 | 0 | |a Soran, H. |e author |
700 | 1 | 0 | |a Su, T.-C. |e author |
700 | 1 | 0 | |a Tomlinson, B. |e author |
700 | 1 | 0 | |a Truong, T.H. |e author |
700 | 1 | 0 | |a Watts, G.F. |e author |
700 | 1 | 0 | |a Yamashita, S. |e author |
773 | |t Journal of Clinical Lipidology |x 19332874 (ISSN) |g 13 2, 287-300 |