Lipid Disorders

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • No emergency indicators identified; routine prioritisation applies
    • Refer to HealthPathways for assessment and management information or local guidelines if available
    • Consider commencing statins in patients with high LDL depending on other cardiac risk factors
    • Managing CVD Risk
    • Patients with hyperlipidemia may be referred to a general physician rather than a cardiologist depending on local services.
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Total triglyceride > 20mmol/L in patients having had episode of pancreatitis (consider referring to Endocrinology or Lipid Clinic if local services are available)
Category 2
(appointment within 90 calendar days)
  • Patients with prior ACS, polyvascular disease and rapidly progressive CVD* and
    • LDL>2.6mmol/L despite (or intolerance to) medical therapy or
    • Dutch Lipid Clinic Network Criteria (DLNC) Score > 6 (i.e.,probable or definite familial hypercholesterolemia)

    • * 2nd or 3rd CV event despite appropriate therapy and compliance
Category 3
(appointment within 365 calendar days)
  • Significantly raised LDL (> 4 mmol/L) in high CVD risk patients despite initial medical therapy
  • Difficult to control LDL (> 2.6 mmol/L) in CHD patients with familial hypercholesterolemia
  • Severe mixed dyslipidaemia (TC and TG more than 10 mmol/L)
  • Young patients with dyslipidaemia with a family history of premature CAD or possible FH (DLNC 3-5)
  • Severe hypertriglyceridemia (>10 mmol/L)
  • Severely elevated Lp(a) >72 nmol/L in patients with an early FH of CVD

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • BP
  • ELFTs, HbA1c, TSH, CK
  • Recent (within 3 months) fasting lipids (cholesterol/ triglyceride/ HDL-cholesterol/ LDL-cholesterol)
  • Medication history including over the counter (OTC) and complementary medications, and adherence assessment

3. Additional referral information Useful for processing the referral

  • Details of all treatments offered and efficacy
  • Relevant previous medical history and co-morbidities (especially cardiovascular disease)
  • Diet history and previous education
  • Smoking and alcohol history
  • Family history of hyperlipidaemia and CVD
  • Dutch Lipid Clinic Network Criteria (DLNC) Score (if available)
  • Serial lipid results (if available)
  • Coronary artery calcium score (if available)
  • CK
  • Estimated probability of a cardiovascular event within the next 5 years, determined using Australian CVD Risk Calculator
  • CT Coronary Artery calcium score (if available)
  • Any imaging confirming presence of cardiovascular disease

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 28 January 2025

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