https://scholars.lib.ntu.edu.tw/handle/123456789/514740
標題: | Comparative aspects of the care of familial hypercholesterolemia in the “Ten Countries Study” | 作者: | Pang J. Chan D.C. Hu M. Muir L.A. Kwok S. Charng M.-J. Florkowski C.M. George P.M. Lin J. Loi D.D. Marais A.D. Nawawi H.M. Gonzalez-Santos L.E. TA-CHEN SU Truong T.H. Santos R.D. Soran H. Tomlinson B. Yamashita S. Ademi Z. Watts G.F. |
關鍵字: | Asia-pacific region; Facilities; Familial hypercholesterolemia; Health care; Services; Southern hemisphere | 公開日期: | 2019 | 出版社: | Elsevier Ltd | 卷: | 13 | 期: | 2 | 起(迄)頁: | 287-300 | 來源出版物: | Journal of Clinical Lipidology | 摘要: | 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 (? = 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 (? = 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 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061756946&doi=10.1016%2fj.jacl.2019.01.009&partnerID=40&md5=4a2d5c26ce0a94e653a11e176dee4ca1 https://scholars.lib.ntu.edu.tw/handle/123456789/514740 |
ISSN: | 1933-2874 | DOI: | 10.1016/j.jacl.2019.01.009 | SDG/關鍵字: | ezetimibe; low density lipoprotein cholesterol; nicotinic acid; probucol; proprotein convertase 9; resin; low density lipoprotein cholesterol; PCSK9 protein, human; proprotein convertase 9; serine proteinase inhibitor; Article; Australia; Brazil; China; cost effectiveness analysis; familial hypercholesterolemia; genetic screening; health care cost; Hong Kong; human; Japan; lipoprotein apheresis; Malaysia; medical specialist; New Zealand; non invasive procedure; Philippines; priority journal; public expenditure; questionnaire; risk assessment; screening test; South Africa; Taiwan; United Kingdom; Viet Nam; apheresis; blood; cardiovascular disease; comparative study; complication; diet therapy; economics; familial hypercholesterolemia; health care delivery; health education; international cooperation; register; reimbursement; Blood Component Removal; Cardiovascular Diseases; Cholesterol, LDL; Delivery of Health Care; Diet Therapy; Health Care Costs; Health Education; Humans; Hyperlipoproteinemia Type II; Insurance, Health, Reimbursement; Internationality; Proprotein Convertase 9; Registries; Risk Assessment; Serine Proteinase Inhibitors |
顯示於: | 醫學系 |
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