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Integration of absolute cardiovascular disease risk assessment into routine blood cholesterol testing at pathology services

journal contribution
posted on 2023-05-20, 13:52 authored by Niamh ChapmanNiamh Chapman, Ricardo Fonseca Diaz, Murfett, L, Beazley, K, Rebekah McWhirterRebekah McWhirter, Martin SchultzMartin Schultz, Mark NelsonMark Nelson, James SharmanJames Sharman
Background: Absolute cardiovascular disease (CVD) risk assessment is recommended for primary prevention of CVD, yet uptake in general practice is limited. Cholesterol requests at pathology services provide an opportunity to improve uptake by integrating absolute CVD risk assessment with this service.

Objective: This study aimed to assess the feasibility of such an additional service.

Methods: Two-hundred and ninety-nine patients (45-74 years) referred to pathology services for blood cholesterol had measurement of all variables required to determine absolute CVD risk according to Framingham calculator (blood pressure, age, sex, smoking and diabetes status via self-report). Data were recorded via computer-based application. The absolute risk score was communicated via the report sent to the referring medical practitioner as per usual practice. Evaluation questionnaires were completed immediately post visit and at 1-, 3- and 6-month follow-up via telephone (n = 262).

Results: Absolute CVD risk reports were issued for 90% of patients. Most patients (95%) reported that the length of time for the pathology service assessment was acceptable, and 91% that the self-directed computer-based application was easy to use. Seventy-eight per cent reported a preference for pathology services to conduct absolute CVD risk assessment. Only 2% preferred a medical practitioner. Of follow-up patients, 202 (75%) had a consultation with a medical practitioner, during which, aspects of CVD risk prevention were discussed (cholesterol and blood pressure 74% and 69% of the time, respectively).

Conclusions: Measurement of absolute CVD risk in pathology services is feasible, highly acceptable among middle-to-older adults and may increase uptake of guideline-directed care in general practice.


Publication title

Family Practice










Menzies Institute for Medical Research


Oxford Univ Press

Place of publication

Great Clarendon St, Oxford, England, Ox2 6Dp

Rights statement

© The Author(s) 2020. Published by Oxford University Press. All rights reserved.

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Socio-economic Objectives

Clinical health not elsewhere classified

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