The characteristics of patients with possible familial hypercholesterolemia - Screening a large payer/provider healthcare delivery system

A. Elis*, M. Leventer-Roberts, A. Bachrach, N. Lieberman, R. Durst, H. Knobler, R. Balicer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Familial hypercholesterolemia (FH) is an under-diagnosed condition. Aim: We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. Methods: A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. Results: The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. Conclusions: By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

Original languageEnglish
Pages (from-to)411-417
Number of pages7
JournalQJM - Monthly Journal of the Association of Physicians
Volume113
Issue number6
DOIs
StatePublished - 1 Jun 2020
Externally publishedYes

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