How confident are you supporting people with familial hypercholesterolaemia?

As a community pharmacist urgent care IP, most of my patient facing practice is supporting people who need help now, but occasionally, on a quite day, I’ll pop on and help the New Medicine Service team.

The last time this happened, the phone was answered by a trainee GP, who told me that they had familial hypercholesterolaemia (FH) and was understandably quite unhappy about their diagnosis. They told me that life-style makes no difference, they did not want to be lectured! It took me off guard, I hadn’t come across this condition before, although there are 40 people affected at the average GP practice albeit that most re undetected. It affects 1 in 250 to 1 in 500 people in the UK.

The person didn’t have any of the secondary causes of hypercholesterolaemia, no uncontrolled hypothyroidism, no uncontrolled diabetes, their BMI was in the normal range, they didn’t smoke and only had the odd drink of alcohol on occasions, they had no cholestatic liver disease, and were not taking cholesterol-raising medicines, and no kidney disease or Cushing’s syndrome.

We talked about their concerns with taking atorvastatin and Ezetimibe and discussed that whilst they were as familiar with the data as I were, data doesn’t tell you if you will be the person who is affected by side effects.

The conversation ended well, but I wasn’t brave enough to correct them on life-style measures. Lifestyle interventions have been shown to have an impact on reducing cholesterol. However, for people with FH, lifestyle advice is not a substitute for lipid-lowering therapy.

If you want to find out more about this topic, book on to the CPPE online workshop on 03/12/2024 ?at 7pm using the following link. Other dates are available. Familial hypercholesterolaemia: supporting people better - focal point : CPPE

Useful information from the course for me in talking to this person was the approximate reductions in LDL cholesterol with different statins and this applies to people with and without FH.

In the workshop you will consider person-centred approaches to reduce people’s risk of cardiovascular disease and improve health outcomes.

After completing all aspects of this workshop, you should be able to:

· recognise the characteristics of an individual that suggest they may have familial hypercholesterolaemia (FH)

· describe the tools commonly used in the initial diagnosis of FH

· refer a person who may need assessment for a diagnosis of FH to an appropriate healthcare professional

· discuss the condition and its impact on cardiovascular risk in a sensitive and person-centred way

· apply the principles of shared decision making to support people living with FH to optimise their treatment

· create a list of resources to enable you to support people living with FH to make lifestyle choices that can reduce their cardiovascular risk.

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