Lipid disorders: FH assessment and diagnosis (new readings)

  • NICE indicator
  • IND261
  • Published:
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Indicator

The percentage of patients with a total cholesterol reading in the preceding 12 months greater than 7.5 mmol/litre who have been:

  • diagnosed with secondary hyperlipidaemia or

  • clinically assessed for familial hypercholesterolaemia or

  • referred for assessment for familial hypercholesterolaemia or

  • genetically diagnosed with familial hypercholesterolaemia.

Indicator type

General practice indicator suitable for use outside the Quality and Outcomes Framework. Committee feedback indicated that there was likely to be less than 20 patients per practice each year with new cholesterol readings above the at-risk threshold.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

Familial hypercholesterolaemia (FH) is a genetic disorder that causes a high cholesterol level and increases the likelihood of coronary artery disease, heart attacks and sudden cardiac death. Current diagnosis rates are below expected prevalence and NICE guidance recommends that FH is considered as a possible diagnosis in people with a total cholesterol level greater than 7.5 mmol/litre. Early detection and genetic diagnosis will lead to provision of appropriate lipid-lowering treatment to lower these risks and improve outcomes. Fasting cholesterol tests should ideally be used but the indicator will search for the earliest high total cholesterol reading in the preceding 12 months.

Source guidance

Familial hypercholesterolemia. NICE guideline CG71 (2008, updated 2019) recommendations 1.1.1, 1.1.5, 1.1.6 and 1.1.8

Specification

Numerator: The number in the denominator with a record of being:

  • diagnosed with secondary hyperlipidaemia at any time or

  • clinically assessed for familial hypercholesterolaemia at any time or

  • referred for assessment for familial hypercholesterolaemia at any time or

  • genetically diagnosed with familial hypercholesterolaemia at any time.

Denominator: The number of patients with a total cholesterol reading in the preceding 12 months greater than 7.5 mmol/litre.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: None.

Personalised care adjustments or exception reporting should be considered to account for situations where the patient is receiving palliative care or declines assessment.

ISBN: 978-1-4731-5796-5