Co-Design of Strategies to Support the Implementation of a Paediatric Risk-Reduction Pathway for Familial...

Area of Science:

• Cardiovascular Medicine
• Public Health
• Implementation Science

Background:

• Familial hypercholesterolaemia (FH) affects 1 in 311 individuals, leading to premature cardiovascular disease if untreated.
• Current paediatric FH detection and management in Australia are suboptimal despite existing guidelines.
• Shared-care models involving general practice, paediatrics, and specialist services show promise but face implementation challenges.

Purpose of the Study:

• To co-develop implementation strategies for a paediatric FH risk-reduction pathway.
• To identify barriers and facilitators to implementing shared-care models for paediatric FH.

Main Methods:

• Qualitative focus-group workshops were conducted with clinical, policy, and advocacy stakeholders.
• Thematic analysis of workshop transcripts identified barriers and facilitators.
• Implementation strategies were mapped using the Consolidated Framework for Implementation Research and Expert Recommendations for Implementing Change.

Main Results:

• Key barriers included unclear responsibilities, limited clinician confidence, and treatment non-adherence.
• Facilitators comprised patient empowerment, financial reimbursement, and clinical champions.
• Nine co-designed strategies were identified, including patient passports, enhanced support, and decision aids.

Conclusions:

• A suite of nine structured and replicable strategies can facilitate shared-care for paediatric FH in Australia.
• These strategies aim to improve early detection and management of FH.
• Further evaluation of the effectiveness and scalability of these strategies in routine care is recommended.