{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T02:24:27Z","timestamp":1794536667028,"version":"4.9.1"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,3,22]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Proprotein convertase subtilisin\/kexin type 9 inhibitors (PCSK9is) are an important but underutilised option to help optimise lipid management. We developed a new service to improve patient access to these medicines in line with National Institute for Health and Care Excellence recommendations. This paper describes the model and provides lipid-lowering results and feedback from the first 100 referred patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The service is based on a centralised multidisciplinary clinic that is the sole prescriber of PCSK9i therapy in the area. Referred patients are assessed for eligibility and given tailored, person-centred support, education and monitoring to promote treatment adherence and lipids optimisation. The clinic also supports referred patients that do not meet PCSK9i eligibility criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the first 100 patients referred (n=62 male; mean age: 62.9\u00b110.5 years), 48 were initiated on PCSK9i therapy. Mean total cholesterol decreased from 7.7\u00b11.6 mmol\/L at baseline to 4.5\u00b11.4 mmol\/L at 3 months (41% reduction), while mean low-density lipoprotein-cholesterol (LDL-C) fell from 5.0\u00b11.6 mmol\/L to 2.1\u00b11.3 mmol\/L (58% reduction; p&lt;0.0001) and median LDL-C decreased from 4.8 mmol\/L to 1.6 mmol\/L (67% reduction) over the same period. These decreases were maintained at 12 months (45%, 65% and 67% reductions, respectively; p<jats:italic>&lt;<\/jats:italic>0.0001 for the decrease in mean LDL-C from baseline). Patient feedback on the clinic was positive and overall satisfaction was high.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This innovative, person-centred, multidisciplinary service successfully initiated PCSK9i therapy for eligible patients and drove long-term monitoring, adherence and cholesterol lowering. It also provided medicines optimisation and adherence assistance to PCSK9i-ineligible patients. The model could be used in other areas to support better uptake and optimisation of PCSK9i therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001931","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T12:51:58Z","timestamp":1649335918000},"page":"e001931","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Innovative, centralised, multidisciplinary medicines optimisation clinic for PCSK9 inhibitors"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9707-234X","authenticated-orcid":false,"given":"Rani","family":"Khatib","sequence":"first","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK"},{"name":"Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK"},{"name":"Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-4887","authenticated-orcid":false,"given":"Mutiba","family":"Khan","sequence":"additional","affiliation":[{"name":"Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Barrowcliff","sequence":"additional","affiliation":[{"name":"Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Ikongo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Burton","sequence":"additional","affiliation":[{"name":"Leeds Centre for Diabetes and Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Leeds Centre for Diabetes and Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Hall","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK"},{"name":"Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"2025081709474980000_9.1.e001931.1","unstructured":"National Institute for Health and Care Excellence . Clinical guideline [CG181]. Cardiovascular disease: risk assessment and reduction, including lipid modification, 2016. 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