One Care recently supported a successful collaborative pilot project alongside the West of England Academic Health Science Network (AHSN) and University Hospitals Bristol and Weston (UHBW) to identify patients with cardiovascular disease (CVD) who could benefit from better lipid management.
CVD causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas.
Reducing cholesterol through improved lipid management is a key way to address CVD. The project aimed to do this by making sure patients could be treated with the right medicines. In the pilot, these medicines included: High Intensity Statins (HIST), Ezetimibe, and PCSK9 inhibitors. The NICE-approved lipid management clinical pathway has since been updated to also include Inclisiran and Bempedoic Acid.
To enable GPs to find the patients who would benefit most, One Care’s business intelligence and digital support teams developed and ran a CVD search tool. Over a year, they supported 10 practices across Bristol, North Somerset and South Gloucestershire to assess more than 149,000 patients and find those with existing CVD who had elevated lipid levels.
Using the tool, they then refined the data using criteria for PCSK9 inhibitor therapy – which treats very high cholesterol – to find eligible patients.
The pilot identified 444 patients who were eligible for medication reviews and referred seven of them to secondary care for PCSK9i therapy.
More broadly, primary care in BNSSG now has a sustainable, standardised way to improve the lipid management of high-risk CVD patients.
Colette Buckley, Head of Digital Support at One Care, said: “We’re really pleased to have been able to bring our digital expertise to the pilot. Delivering the tool has helped ensure patients across our region are taking the most effective CVD medication, and provided a valuable pathway that can be used more widely in future. Enabling this kind of collaboration and helping to develop ways to help general practice and patients is at the heart of what we do.”
The pilot, led by Dr Paula Rostek, was part of the West of England Academic Health Science Network’s Rapid Uptake Products programme.
Clare Evans, Deputy Director of Service and System Transformation at the West of England AHSN said: “As a result of this pilot project, and the One Care tool, a sustainable pathway has been developed for Bristol, North Somerset and South Gloucestershire to optimise the lipid management of high-risk patients in primary care. This will support a standardised, evidence-based approach to manage those with established cardiovascular disease. Delivered alongside the pressures of the pandemic, the work of everybody involved is to be commended.”
Following the pilot, One Care will shortly launch the second phase of the tool. A second tool, to help identify patients who may have undiagnosed Familial Hypercholesterolaemia (FH), will also be offered. More information about these tools is available here.