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Research ArticlePractice

Simplified lipid guidelines

Prevention and management of cardiovascular disease in primary care

G. Michael Allan, Adrienne J. Lindblad, Ann Comeau, John Coppola, Brianne Hudson, Marco Mannarino, Cindy McMinis, Raj Padwal, Christine Schelstraete, Kelly Zarnke, Scott Garrison, Candra Cotton, Christina Korownyk, James McCormack, Sharon Nickel and Michael R. Kolber
Canadian Family Physician October 2015, 61 (10) 857-867;
G. Michael Allan
Professor and Director of Evidence-based Medicine in the Department of Family Medicine at the University of Alberta in Edmonton and Director of the Evidence and CPD program of the Alberta College of Family Physicians.
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  • For correspondence: mgallan@ualberta.ca
Adrienne J. Lindblad
Knowledge Translation and Evidence Coordinator for the Alberta College of Family Physicians and Associate Clinical Professor in the Department of Family Medicine at the University of Alberta.
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Ann Comeau
Primary Care Manager and a nurse practitioner for the Edmonton Southside Primary Care Network.
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John Coppola
Clinical Assistant Professor in the Department of Family Medicine in the Cumming School of Medicine at the University of Calgary in Alberta.
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Brianne Hudson
Family physician in Grande Prairie, Alta.
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Marco Mannarino
Assistant Clinical Professor and Clinic Preceptor in the Department of Family Medicine at the University of Alberta.
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Cindy McMinis
Clinical Practice Leader in Pharmacy Services for Alberta Health Services in Wainwright, Alta.
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Raj Padwal
Associate Professor in Clinical Epidemiology, Clinical Pharmacology, and General Internal Medicine and Director of the Hypertension Clinic at the University of Alberta.
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Christine Schelstraete
Virtual care nurse for MyHome Health pilot project in the Sherwood Park-Strathcona County Primary Care Network in Alberta.
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Kelly Zarnke
Associate Professor of Medicine and Head of the Division of General Internal Medicine in the Faculty of Medicine at the University of Calgary and Section Chief of General Internal Medicine for the Alberta Health Services Calgary Zone.
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Scott Garrison
Associate Professor in the Department of Family Medicine at the University of Alberta.
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Candra Cotton
Clinical pharmacist at Saint-Vincent Hospital in Ottawa, Ont.
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Christina Korownyk
Associate Professor in the Department of Family Medicine at the University of Alberta.
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James McCormack
Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia in Vancouver.
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Sharon Nickel
Coordinator of the Evidence and CPD program of the Alberta College of Family Physicians.
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Michael R. Kolber
Associate Professor in the Department of Family Medicine at the University of Alberta.
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Abstract

Objective To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focused on the highest level of evidence available.

Methods Nine health professionals (4 family physicians, 2 internal medicine specialists, 1 nurse practitioner, 1 registered nurse, and 1 pharmacist) and 1 nonvoting member (pharmacist project manager) comprised the overarching Lipid Pathway Committee (LPC). Member selection was based on profession, practice setting, and location, and members disclosed any actual or potential conflicts of interest. The guideline process was iterative through online posting, detailed evidence review, and telephone and online meetings. The LPC identified 12 priority questions to be addressed. The Evidence Review Group answered these questions. After review of the answers, key recommendations were derived through consensus of the LPC. The guidelines were drafted, refined, and distributed to a group of clinicians (family physicians, other specialists, pharmacists, nurses, and nurse practitioners) and patients for feedback, then refined again and finalized by the LPC.

Recommendations Recommendations are provided on screening and testing, risk assessments, interventions, follow-up, and the role of acetylsalicylic acid in primary prevention.

Conclusion These simplified lipid guidelines provide practical recommendations for prevention and treatment of CVD for primary care practitioners. All recommendations are intended to assist with, not dictate, decision making in conjunction with patients.

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Canadian Family Physician: 61 (10)
Canadian Family Physician
Vol. 61, Issue 10
1 Oct 2015
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Simplified lipid guidelines
G. Michael Allan, Adrienne J. Lindblad, Ann Comeau, John Coppola, Brianne Hudson, Marco Mannarino, Cindy McMinis, Raj Padwal, Christine Schelstraete, Kelly Zarnke, Scott Garrison, Candra Cotton, Christina Korownyk, James McCormack, Sharon Nickel, Michael R. Kolber
Canadian Family Physician Oct 2015, 61 (10) 857-867;

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Simplified lipid guidelines
G. Michael Allan, Adrienne J. Lindblad, Ann Comeau, John Coppola, Brianne Hudson, Marco Mannarino, Cindy McMinis, Raj Padwal, Christine Schelstraete, Kelly Zarnke, Scott Garrison, Candra Cotton, Christina Korownyk, James McCormack, Sharon Nickel, Michael R. Kolber
Canadian Family Physician Oct 2015, 61 (10) 857-867;
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