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Trial registered on ANZCTR
Registration number
ACTRN12615000153516
Ethics application status
Approved
Date submitted
30/01/2015
Date registered
17/02/2015
Date last updated
13/01/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
A proof of concept study to identify familial hypercholesterolaemia in primary care
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Scientific title
A proof of concept study to identify familial hypercholesterolaemia (FH) among 18 - 40 year old patients presenting in a primary care setting
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Secondary ID [1]
286076
0
NIL
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Universal Trial Number (UTN)
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Trial acronym
POCT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
familial hypercholesterolaemia
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Condition category
Condition code
Cardiovascular
294375
294375
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0
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Other cardiovascular diseases
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Human Genetics and Inherited Disorders
294487
294487
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is a proof of concept study:
Recruitment of patients will take place over 5 months.
Patients presenting to general practitioner (GP) will be invited to participate. Upon consent GP or practice nurse (PN) will undertake a non-fasting finger prick test using the Cardiocheck PA analyser to measure patient's LDL-c level. If level is above 4.9mmol/L, a fasting lipid blood test will be carried out to confirm the results. If a level above 4.9mmol/L is maintained, patient will be recalled and assessed using the Dutch Lipid Clinic Network Score (DLCNS) for FH. Patients with a score under or equal to 5 will be classed as low complexity FH and managed at the discretion of the GP. Patients with a score above 5 will be referred for FH in a shared care model between GP and specialist. As part of clinical care, first degree relatives will also be offered further investigations for FH.
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Intervention code [1]
291066
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Early detection / Screening
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Intervention code [2]
291072
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Diagnosis / Prognosis
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Comparator / control treatment
uncontrolled. This is a proof of concept study of protocol feasibility.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Frequencies of unlikely, possible, probable, definite familial hypercholesterolaemia patients will be determined. The study will use the Dutch Lipid Clinic Network Scoring system to class patients into the mentioned (unlikely, possible, probable and definite) FH categories
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Assessment method [1]
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Timepoint [1]
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over 5 months
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Secondary outcome [1]
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The suitability of the protocol for integration into general practice will be determined using semi structured interviews and focus groups
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Assessment method [1]
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Timepoint [1]
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within 5 months of the end of recruitment phase
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Secondary outcome [2]
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The post-study awareness of FH among participants and practice staff will be assessed using semi structured interviews and focus groups.
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Assessment method [2]
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Timepoint [2]
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within 5 months of the end of recruitment phase
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Secondary outcome [3]
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The sustainability of the protocol will be determined using both results from the qualitative assessments and the cost analysis of the trial
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Assessment method [3]
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Timepoint [3]
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Within 5 months of the end of recruitment phase
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Eligibility
Key inclusion criteria
patients, 18 - 40 years of age, who are presenting to their GP for any consultation.
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Less than 18 or more than 40 years of age
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients, of 18 to 40 years of age, presenting to their GP for any consultation will be invited to participate. Patient will undergo finger prick LDL-c test if they consent to participating. LDL-c levels >4.9mmol/L will be rechecked using a fasting blood samples. Patients with confirmatory high levels of LDL-c will be investigated for FH using the Dutch Lipid network scoring system. Treatment options will be presented to those in the probable and definite FH category as part of GP's clinical care
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable. convenience sampling
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Convenience sampling of patients, aged 18-40years, presenting to their GP for any consultation. All consented patients will have their LDL-c tested using a finger-prick test. Only those with levels > 4.9mmol/L will require a confirmatory fasting blood test. Patients with confirmed LDL-c levels >4.9mmol/L will have their risks of FH assessed using the Dutch Lipid Clinic Network scoring system. Patients classed as probable or definite FH will be given treatment options as part of GP's clinical care
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
This is a proof of concept study of protocol feasibility and therefore sample sizes do not require statistical power. Sample size is based on convenience sampling.
Percentage for possible, unlikely, probable, definite Familial hypercholesterolaemia using the number screened as the denominator. Interpretive Phenomenological Analysis (IPA) for interviews and Thematic Analysis for focus groups. Descriptive cost analysis will be used.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
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Date of first participant enrolment
Anticipated
1/04/2015
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Actual
4/05/2015
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Date of last participant enrolment
Anticipated
2/09/2015
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Actual
27/10/2015
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Date of last data collection
Anticipated
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Actual
12/11/2015
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Sample size
Target
500
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Accrual to date
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Final
199
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Primary Health Care Research Institute (APHCRI)
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Address [1]
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Australian Primary Health Care Research Institute
Building 63
Cnr. Mills and Eggleston Rd
The Australian National University
CANBERRA ACT 0200
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Country [1]
290666
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Australia
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Primary sponsor type
Individual
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Name
Prof Tom Brett
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Address
The University of Notre Dame Australia
19 Mouat Street, Fremantle WA 6959
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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A/Prof Diane Arnold-Reed
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Address [1]
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The University of Notre Dame Australia
19 Mouat Street, Fremantle, WA 6959
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Country [1]
289359
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Winthrop Prof Gerald Watts
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Address [1]
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University of Western Australia
Level 4, MRF Building
Rear 50 Murray Street,
Perth, WA 6000
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Country [1]
278309
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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A/Prof Caroline Bulsara
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Address [2]
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The University of Notre Dame Australia
19 Mouat Street, Fremantle, WA 6959
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Country [2]
278310
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Prof Alistair Vickery
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Address [3]
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University of Western Australia
M706, 35 Stirling Highway
Crawley, WA 6009
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Country [3]
278311
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Prof Max Bulsara
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Address [4]
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The University of Notre Dame Australia
19 Mouat Street, Fremantle, WA 6959
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Country [4]
278312
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Australia
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Other collaborator category [5]
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Individual
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Name [5]
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Dr Lakhina Troeung
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Address [5]
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The University of Notre Dame Australia
19 Mouat Street, Fremantle, WA 6959
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Country [5]
278313
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Australia
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Other collaborator category [6]
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Individual
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Name [6]
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Dr Jing Pang
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Address [6]
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University of Western Australia
Level 3, MRF building
Rear 50 Murray Street,
Perth WA 6000
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Country [6]
278314
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Australia
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Other collaborator category [7]
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Individual
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Name [7]
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Dr Wendy Chan She Ping-Delfos
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Address [7]
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The University of Notre Dame Australia
19 Mouat Street, Fremantle, WA 6959
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Country [7]
278315
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The University of Notre Dame Australia Human Research Ethics Committee
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Ethics committee address [1]
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19 Mouat Street, Fremantle, WA 6959
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Ethics committee country [1]
292295
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Australia
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Date submitted for ethics approval [1]
292295
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03/03/2015
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Approval date [1]
292295
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02/04/2015
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Ethics approval number [1]
292295
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015024F
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Summary
Brief summary
Familial Hypercholesterolaemia (FH) is an inherited condition which results in excessively high levels of cholesterol in the bloodstream from birth, with increased risk of heart problems by age 40 or earlier if not treated. Early diagnosis and treatment are very effective and reduces long-term disease costs. This study examines the feasibility of employing a new method of detecting FH through GP clinics using a finger prick cholesterol blood test. If FH is diagnosed, close relatives will also be checked so early treatment can be offered. This proposed innovative approach will alleviate hospital load and allow FH to be managed by the patient’s GP and lipid specialist in shared care approach
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Trial website
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Trial related presentations / publications
Chan She Ping-Delfos W, Brett T, Arnold-Reed D, Watts G, Bulsara C, Vickery A. (2015). A proof of concept study to identify familial hypercholesterolaemia (FH) in primary care. In: 2015 Primary Health Care Research Conference: Program & Abstracts. Primary Health Care Research and Information Service, Australia. phcris.org.au/conference/abstract/8049 Wendy Chan She Ping-Delfos, Tom Brett, Diane Arnold-Reed (2016). A proof of concept study to identify Familial Hypercholesterolaemia in primary care. http://aphcri.anu.edu.au/files/Brett%20Key%20Messages%20%20FINAL.pdf Wendy Chan She Ping-Delfos, Tom Brett, Diane Arnold-Reed (2016). A proof of concept study to identify Familial Hypercholesterolaemia in primary care. http://aphcri.anu.edu.au/files/Brett%20Policy%20Options%20%20FINAL%20doc.pdf Wendy Chan She Ping-Delfos, Tom Brett, Diane Arnold-Reed (2016). A proof of concept study to identify Familial Hypercholesterolaemia in primary care. http://aphcri.anu.edu.au/files/Brett%20Full%20report%20FINAL.pdf
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Public notes
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Contacts
Principal investigator
Name
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Prof Tom Brett
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Address
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The University of Notre Dame Australia
19 Mouat Street
Fremantle, WA 6959
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Country
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Australia
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Phone
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+61 8 9433 0571
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Tom Brett
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Address
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The University of Notre Dame Australia
19 Mouat Street,
Fremantle, WA 6959
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Country
54507
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Australia
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Phone
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+61 8 9433 0571
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Fax
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Email
54507
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[email protected]
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Contact person for scientific queries
Name
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Tom Brett
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Address
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The University of Notre Dame Australia
19 Mouat Street,
Fremantle, WA 6959
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Country
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Australia
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Phone
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+61 8 9433 0571
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Fax
54508
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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