Physicians’ Lack of Adherence to National Heart, Lung, and Blood Institute Guidelines for Pediatric Lipid Screening

Valle, Christopher; Binns, Helen J.; Quadri-Sheriff, Maheen; Benuck, Irwin; Patel, Angira

doi:10.1177/0009922815576885

Cited by 31 publications

(26 citation statements)

References 17 publications

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“…The continued low rates of lipid testing in our study are similar to several other studies that have examined lipid testing via phone surveys and record reviews of well-child visits ( Kimm et al, 1998 , Vinci et al, 2014 , Kimm et al, 1990 , Valle et al, 2015 , Wilson et al, 2015 ). Data from the National Ambulatory Medical Care Survey involving health maintenance visits among patients aged 2–19 years revealed lipid test orders in only 3% of visits and negligible increase in testing rates (2.5% in 1995 to 3.2% in 2010) ( Vinci et al, 2014 ).…”

Section: Discussionsupporting

confidence: 87%

Temporal trends in lipid testing among children and adolescents: A population based study

Sriram

Sauver

Jacobson

et al. 2017

Preventive Medicine Reports

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Unfavorable lipid levels during childhood are associated with subsequent development of atherosclerotic cardiovascular disease. The American Academy of Pediatrics and National Heart, Lung and Blood Institute in 2011 recommended universal lipid screening for children between ages 9–11 years and between ages 17–21 years. The objective of the study was to determine temporal trends in lipid testing among children and young adults in a mid-western population. The Rochester Epidemiology Project database was used to identify lipid testing in ages 2–21 years (n = 51,176) in the Olmsted County population from January 1, 2008 through December 31, 2014. Generalized estimating equations with Poisson distribution were used to test for temporal trends in lipid testing across the age groups. There was modest increase in lipid testing in children in the age groups, 9–11 years and 17–21 years (1.5% in 2008 to 2.2% in 2014, P < 0.001 and 4.4% in 2008 to 4.6% in 2014, P = 0.02, respectively). There was a significant decrease in proportion of 17–21 year olds with elevated total cholesterol (16.2% in 2008 to 11.6% in 2014; P = 0.01) and non-high density lipoprotein cholesterol (22.6% in 2008 to 12.6% in 2014; P < 0.001). In this population-based study, rates of lipid testing increased minimally only in the last six years. Further longitudinal studies are warranted to improve guideline dissemination and address attitudes, practices and barriers to lipid testing in children and young adults.

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Section: Discussionsupporting

confidence: 87%

Temporal trends in lipid testing among children and adolescents: A population based study

Sriram

Sauver

Jacobson

et al. 2017

Preventive Medicine Reports

View full text Add to dashboard Cite

show abstract

“…16 Reviews of records from 1 or more practices suggest more frequent screening (17%-27%), but still at relatively low rates and primarily in children with higher risk conditions such as obesity or family history of cardiovascular disease. 17,18 A large review of the records of children enrolled in managed care organizations (n = 301 080) between 2007 and 2010 found only 10% of pediatric patients had lipid testing. 19 Other data actually suggest a decline in lipid testing among children in recent years.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol Screening and Treatment Practices and Preferences: A Survey of United States Pediatricians

Ferranti

Rodday

Parsons

et al. 2017

The Journal of Pediatrics

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“…These educational components supported open discussions with outside referring physicians and patients to “ get them up to speed ” regarding the appropriateness of elective PCIs, obtaining the needed pre-procedural information from the providers, and encouraging appropriate documentation of the AUC by staff and cardiologists. The literature has identified education to be a key component in the adherence to AUC as well as educational interventions that could be generalized to other practice environments [ 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of barriers and facilitators in the implementation of appropriate use criteria for elective percutaneous coronary interventions: a qualitative study

Lambert-Kerzner

Maynard

McCreight

et al. 2018

BMC Cardiovasc Disord

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BackgroundThe use of inappropriate elective Percutaneous Coronary Intervention (PCI) has decreased over time, but hospital-level variation in the use of inappropriate PCI persists. Understanding the barriers and facilitators to the implementation of Appropriate Use Criteria (AUC) guidelines may inform efforts to improve elective PCI appropriateness.MethodsAll hospitals performing PCI in Washington State were categorized by their use of inappropriate elective PCI in 2010 to 2013. Semi-structured, qualitative telephone interviews were then conducted with 17 individual interviews at 13 sites in Washington State to identify barriers and facilitators to the implementation of the AUC guidelines. An inductive and deductive, team-based analytical approach, drawing primarily on Matrix analysis was performed to identify factors affecting implementation of the AUC.ResultsSpecific facilitators were identified that supported successful implementation of the AUC. These included collaborative catheterization laboratory environments that allow all staff to participate with questions and opinions; ongoing AUC education with catheterization laboratory teams and referring providers; internal AUC peer review processes; interventional cardiologist be directly involved with the pre-procedural review process; checklist-based algorithms for pre-procedural documentation; systems redesign to include insurance companies; and AUC educational information with patients. Barriers to implementation of the AUC included external pressures, such as competition for patients, and the lack of shared medical records with sites that referred patients for coronary angiography.ConclusionsThe identified facilitators enabled sites to successfully implement the AUC. Catheterization laboratories struggling to successfully implement the AUC may consider utilizing these strategies to improve their processes to improve patient selection for elective PCI.

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Physicians’ Lack of Adherence to National Heart, Lung, and Blood Institute Guidelines for Pediatric Lipid Screening

Cited by 31 publications

References 17 publications

Temporal trends in lipid testing among children and adolescents: A population based study

Temporal trends in lipid testing among children and adolescents: A population based study

Cholesterol Screening and Treatment Practices and Preferences: A Survey of United States Pediatricians

Assessment of barriers and facilitators in the implementation of appropriate use criteria for elective percutaneous coronary interventions: a qualitative study

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