Applying implementation science to improve care for familial hypercholesterolemia

Abstract

Purpose of reviewImproving care of individuals with familial hypercholesteremia (FH) is reliant on the synthesis of evidence-based guidelines and their subsequent implementation into clinical care. This review describes implementation strategies, defined as methods to improve translation of evidence into FH care, that have been mapped to strategies from the Expert Recommendations for Implementing Change (ERIC) compilation.Recent findingsA search using the term ‘familial hypercholesterolemia’ returned 1350 articles from November 2018 to July 2021. Among these, there were 153 articles related to improving FH care; 1156 were excluded and the remaining 37 were mapped to the ERIC compilation of strategies: assess for readiness and identify barriers and facilitators [9], develop and organize quality monitoring systems [14], create new clinical teams [2], facilitate relay of clinical data to providers [4], and involve patients and family members [8]. There were only 8 of 37 studies that utilized an implementation science theory, model, or framework and two that explicitly addressed health disparities or equity.SummaryThe mapping of the studies to implementation strategies from the ERIC compilation provides a framework for organizing current strategies to improve FH care. This study identifies potential areas for the development of implementation strategies to target unaddressed aspects of FH care.

Designing implementation strategies to improve identification, cascade testing, and management of families with familial hypercholesterolemia: An intervention mapping approach

“…The application of principles from implementation science to the field of FH has been discussed in many recent articles including original research, reviews, commentaries, and guidelines (53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). By leveraging implementation science, which aims to close the large gap from knowledge generation to implementation into practice, we can improve every component of FH care.…”

Impact of a Population Genomic Screening Program on Health Behaviors Related to Familial Hypercholesterolemia Risk Reduction

“…23 Clinician and patient knowledge related to FH impacts care from identification to treatment. [24][25][26][27] Once identified, access to treatment can be difficult. Low prescribing of PCSK9 inhibitors due to access problems is consistent with a large cohort study conducted by the Family Heart Foundation (previously the FH Foundation).…”

Translating guidelines into practice via implementation science: an update in lipidology

“…In addition, the authors noted that future work should be focused on thoroughly defining these implementation strategies with over half missing the temporality and dose of these strategies so that they could be replicated in future studies [27 ▪ ]. The other review article, which focused on 37 studies for improving care for individuals with familial hypercholesterolemia, mapped the implementation strategies used [28 ▪ ]. The implementation strategies included assess for readiness, identify barriers and facilitators, develop and organize quality monitoring systems, create new clinical teams, facilitate relay of clinical data to providers, and involve patients and family members [28 ▪ ].…”

“…The other review article, which focused on 37 studies for improving care for individuals with familial hypercholesterolemia, mapped the implementation strategies used [28 ▪ ]. The implementation strategies included assess for readiness, identify barriers and facilitators, develop and organize quality monitoring systems, create new clinical teams, facilitate relay of clinical data to providers, and involve patients and family members [28 ▪ ]. This review found that 22% of the studies used an implementation science theory, model, or framework to conduct their analysis [28 ▪ ].…”