Evaluation of Lipids & Familial Hypercholesterolaemia (FH) national spread programme

11th June 2024

The aim of this project was to understand how lipid management prescribing volumes and variation had changed as a result of the programme, how knowledge of the NICE pathway had changed amongst clinicians and patients, understand the key levers and barriers to success, and explore wider benefits of the programme.

Analysis of routinely collected data from the Health Innovation Network (HIN) alongside publicly available data sources allowed for complex statistical methods, to be undertaken which identified that adoption of the programme was associated within increases in prescribing rates.

A panel regression analysis identified that adoption of the programme was associated with 10% of the total increase in ezetimibe prescribing rates, and 25% of the increase in PCSK9i prescribing rates.

Undertaking semi-structured interviews with 25 stakeholder organisations and individuals associated with managing and spreading of the programme identified the importance of aligning the programme aims with both national and local strategic priorities, and of early and wide ranging communications to both understand potential concerns and barriers, and to recruit advocates at all levels who can positively reinforce the efforts and aims.

The lipids and FH national spread programme was ambitious in both its scale and size, and coincided with COVID, and with multiple system-level changes, each of which necessitated adaptations to scope and management. Despite these barriers, there is strong evidence illustrating the education which has taken place in Primary Care, and clear lessons around the importance of communications, strategy, and infrastructure requirements which can be adopted in future spread programmes across the Health Innovation Network. The interviews revealed that the work which this programme initiated will continue both through HINs and where it has been embedded in the system, and the statistical analysis identified emerging evidence to suggest that the programme has helped to drive up prescribing rates.

Our Impact

The independent evaluation was able to generate evidence across three key areas.

Firstly, that while this was a challenging project due to scale and scope of the work involved, staff were overwhelmingly positive about their experience, and that systems have begun to embed learning such that the work undertaken will be continued in the system as HINs move to a sustainability level of support.

Secondly, the statistical analysis was able to identify that adoption of the programme was associated with an additional 9,971 people receiving lipid lowering therapies.

Finally, the qualitative findings and learnings can be applied to future large-scale programme implementation to maximise the impact and understand where efficiencies may lie.

This independent evaluation was able to provide the Health Innovation Network with both retrospective findings related to the programme’s impact, and with prospective findings to support future innovation and adoption projects. We are looking forward to seeing discussion of the findings at ConfedExpo in June 2024.

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