Study reveals haphazard cholesterol checks

There are concerns patients at high risk of heart disease are not having their cholesterol checked enough in Australia.

An Australian study, published in the British Medical Journal Open, found nearly half of patients on lipid-lowering medication – used to treat high cholesterol, a key risk factor for cardiovascular disease – may be having fewer than the recommended number of high-density lipoprotein (HDL-C) tests.

The analysis of data from the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme also revealed nearly one fifth of patients had more tests than is recommended.

The authors suggested many Australians may be at risk of developing cardiovascular disease because health checks were not being administered according to national guidelines.

“Cholesterol tests are being administered in a haphazard manner – with some patients being tested too frequently and others not enough,” said co-author Dr Evan Atlantis, from the School of Nursing and Midwifery at Western Sydney University.

Australian guidelines by the Royal Australian College of General Practitioners (RACGP) recommend testing every five years for low-risk patients and every 12 months for those considered at high risk of heart disease.

To examine if the guidelines were be followed, a research team from Western Sydney University, Capital Markets CRC, University of Sydney and University of Adelaide did an analysis of publicly available, linked patient records within the electronic databases of the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefit Scheme (PBS).

The results revealed 49 per cent of patients on medications to lower their cholesterol did not have the recommended annual HDL-C test in a given year, while 19 per cent of the same population received more HDL-C tests than were necessary.

While the cause of the high underutilisation rate is uncertain, the number of affected people is large and of concern, said co-author Dr Katy Bell from the University of Sydney.

“If there is high level evidence that the recommended frequency of tests leads to improved health outcomes, then the potential underutilisation of these tests in Australia warrants further attention,” she said.