A hospital-based network for hyperlipidaemia management and cardiovascular disease prevention.
OBJECTIVE
A number of studies have shown that there is a wide gap between scientific evidence and clinical practice. In particular, less than 50% of the patients surviving a myocardial infarction take lipid lowering agents. We have developed an organisational model designed to bridge this gap and implement clinical guidelines in a clinical setting.


RESULTS
We have set up 23 clinics for the management of hyperlipidaemia and the prevention of cardiovascular disease. The procedure for establishing these clinics included the training of health staff, the preparation of a medical record, the development of a standard operating protocol, the presentation of the aims and operating procedure of the network to general practitioners and the community, the institution of a freephone number, and the standardisation of quality control. The regional clinical network was established in 1998, and examined 1534 patients during the first four months. As expected, the most frequent hyperlipoproteinaemia was polygenic hypercholesterolaemia (30% of males and 32% of females). Fifty-three percent of the 270 patients asking for long-term follow-up reached an acceptable target according to the international guidelines (total cholesterol < 220 mg/dL) in the first two months.


CONCLUSIONS
This organisational model takes advantage of hospital units, which devote a fraction of their time to the prevention of cardiovascular disease. The network is useful for standardising diagnostic and therapeutic procedures in accordance with the guidelines, and has an educational impact on both patients and health staff. The availability of a large database of patients with hyperlipoproteinaemia is the basis for quality control, drug safety surveillance, and clinical studies of specific issues or selected patient subgroups. The hospital-based network is an operational reference for all practitioners in the region and helps to integrate efforts aimed at bridging the gap between scientific evidence and clinical practice.
Pujia
A
A
Dipartimento di Medicina Sperimentale e Clinica, Università di Catanzaro, Via T. Campanella, 88100 Catanzaro, Italy. pujia@unicz.it
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017146:Models, Organizational; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012041:Regional Medical Programs
D000960:Hypolipidemic Agents