I have no recent experience of supporting cholesterol measurement in the community, but I was involved in a British Heart Foundation project in conjunction with Leeds University some years ago (late 80s early 90s-ish).
It was aimed at workplaces, ie commercial and public sector, in and around Leeds and used Reflotrons. Nurses employed on the project visited companies by invitation (a "donation" of £10 per person seen was invited - this covered consumables costs and their salaries) and the cholesterol was measured in the context of a lifestyle interview including weight and BP measurement and advice on smoking, exercise and diet. We used the Birmingham EQA (it had just started then, I think) and all the nurses were trained in use of the equipment and the theory and practice of QC/EQA. Patients with high cholesterols were referred to their GP and told that a lab result should be regarded as definitive.
The project folded because of fall in demand from companies in the early 90s recession, but their feedback on it had been very positive. Of course, my time and the input of clinical academics were not funded via the project income, so it would be very difficult to fund something similar now.
I've no problem in principle with community cholesterol screening, but only if it's properly conducted (ie training, EQA etc) and preferably in a "lifestyle" context. The advantage of POCT here is, as always, the immediacy, so that the patient can be advised on the spot and appropriate referral/followup arranged, probably including lab analysis. Interesting to speculate on how this might be funded!
Dr MJ Pearson
Department of Clinical Biochemistry & Immunology
Old Medical School
Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust)
LEEDS LS1 3EX
UK
tel (44)-113-392-3945
fax (44)-113-343-5672
http://www.leedsteachinghospitals.com
>>> "Frost, Stephen" <[log in to unmask]> 03/10/04 10:48am >>>
Hello to you all. Apologies for cross posting.
I wondered what your current views are on cholesterol measurement in the
community and whether this should be supported by the laboratory. I have
been approached recently by nursing/health visitors in neighbouring local
PCTs for advice on appropriate equipment and whether we feel cholesterol
measurement should be included in community health screening sessions. I was
involved in local community QA support about ten years ago but this seemed
to fade away. NSFs and such like may be raising interest again, together
with TV cereal adverts. 'Know your number and lower it.'
In particular, can you answer any of the following:
Do you support this type of measurement in principle?
Is POCT preferable to sending samples to the lab or visa versa?
Does anyone provide active QA or QC support for POCT cholesterol? If so what
do you use?
What is the current equipment available and what is most suitable? Anyone
measure other lipids by POCT?
Does anyone have a direct financial/budgetary involvement in any way?
Does anyone provide operating guidelines or training, or other specific
advice e.g. related to sample handling, follow up of abnormals etc.?
A non UK perspective would also be interesting.
Best wishes
Steve
Dr Stephen Frost
BSUH Trust
PRH Hospital, Sussex
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|