Determinants of lipid-lowering medication prescribing in a multi-ethnic adult population diagnosed with familial hypercholesterolaemia in South London

Familial hypercholesterolaemia (FH) (prevalence 1 in 250) is an inherited condition that significantly increases risk of premature cardiovascular disease. Early diagnosis can potentially normalise cardiovascular risk with lipid-lowering medicines (statins and fibrates). Only 7% of patients with FH a...

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Published in:British journal of general practice 2023-07, Vol.73 (suppl 1), p.bjgp23X734145
Main Authors: Ayoub, Aya, Akyea, Ralph, L'Esperance, Veline, Ayis, Salma, Parmar, Divya, Durbaba, Stevo, Fisher, Mark, Patel, Riyaz, Harding, Seeromanie, Wierzbicki, Anthony S, Qureshi, Nadeem, Molokhia, Mariam
Format: Article
Language:English
Subjects:
Adult
Cardiovascular disease
Comorbidity
Cross-Sectional Studies
Diabetes
Diabetes Mellitus
Ethnicity
Health risks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipoproteinemia Type II - complications
Hyperlipoproteinemia Type II - diagnosis
Hyperlipoproteinemia Type II - drug therapy
Hypertension - complications
Hypertension - drug therapy
Hypertension - epidemiology
Lipids
London - epidemiology
Male
Medical treatment
Retrospective Studies
Risk Factors
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Summary:Familial hypercholesterolaemia (FH) (prevalence 1 in 250) is an inherited condition that significantly increases risk of premature cardiovascular disease. Early diagnosis can potentially normalise cardiovascular risk with lipid-lowering medicines (statins and fibrates). Only 7% of patients with FH are identified in the UK. Improving identification, and understanding disparities in ascertainment and management, is an NHS priority. To assess determinants of lipid-lowering prescribing in ethnically diverse adults with an FH code METHOD: Retrospective cross-sectional analysis of Lambeth DataNet, containing anonymised adult patient data from 41 practices in South London. Stata 17 was used to run sequential multilevel logistic regression models, adjusted for practice effects, to estimate the odds of no lipid-lowering prescription in FH-coded adults; this was assessed across 10 ethnic groups and other patient-level factors: demographic, socioeconomic, lifestyle, comorbidities, and practice factors (consultation frequency and practice list size). One hundred and sixty-one of 801 (20%) of adults with an FH code received no lipid-lowering medication. The fully adjusted model for no lipid-lowering prescriptions showed the following associations: age (years) odds ratio (OR) 0.93 (
ISSN:0960-1643
1478-5242
DOI:10.3399/bjgp23X734145