The American journal of medicine · 2011
Barriers to non-HDL cholesterol goal attainment by providers.
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Virani Salim S, Steinberg Lynne, Murray Tyler, Negi Smita, Nambi Vijay, Woodard LeChauncy D, Bozkurt Biykem, Petersen Laura A, Ballantyne Christie M
Аннотация
PURPOSE: Despite improvements in low-density lipoprotein cholesterol goal attainment, non-high-density lipoprotein cholesterol (non-HDL-C) goal attainment remains poor. This study assessed providers' knowledge of, attitude toward, and practice regarding non-HDL-C.
METHODS: Based on a conceptual model, we designed a questionnaire that was administered to internal medicine, family practice, cardiology, and endocrinology providers attending continuous medical education conferences. Responses were compared with those of providers attending a clinical lipidology conference.
RESULTS: The response rate was 33.3% (354/1063). Among providers attending nonlipidology conferences, only 26% knew that non-HDL-C was a secondary treatment target, 34% knew non-HDL-C treatment goals, 56% could calculate non-HDL-C levels, and 66% knew that non-HDL-C levels could be calculated from a standard lipid panel. Compared with providers attending the lipidology conference, the other providers were less likely (P≤.01) to have read the Adult Treatment Panel III guidelines (46% vs 98%) or to use non-HDL-C (36% vs 91%). No differences were found between primary care and specialty providers. Lack of familiarity with Adult Treatment Panel III guidelines (34%) and of knowledge regarding non-HDL-C importance (21%) and calculation (22.7%) were the most common barriers identified.
CONCLUSIONS: Major gaps remain in providers' awareness regarding non-HDL-C definition, calculation, and goals. System-level interventions are needed across specialties to address these gaps.
METHODS: Based on a conceptual model, we designed a questionnaire that was administered to internal medicine, family practice, cardiology, and endocrinology providers attending continuous medical education conferences. Responses were compared with those of providers attending a clinical lipidology conference.
RESULTS: The response rate was 33.3% (354/1063). Among providers attending nonlipidology conferences, only 26% knew that non-HDL-C was a secondary treatment target, 34% knew non-HDL-C treatment goals, 56% could calculate non-HDL-C levels, and 66% knew that non-HDL-C levels could be calculated from a standard lipid panel. Compared with providers attending the lipidology conference, the other providers were less likely (P≤.01) to have read the Adult Treatment Panel III guidelines (46% vs 98%) or to use non-HDL-C (36% vs 91%). No differences were found between primary care and specialty providers. Lack of familiarity with Adult Treatment Panel III guidelines (34%) and of knowledge regarding non-HDL-C importance (21%) and calculation (22.7%) were the most common barriers identified.
CONCLUSIONS: Major gaps remain in providers' awareness regarding non-HDL-C definition, calculation, and goals. System-level interventions are needed across specialties to address these gaps.
Предметные рубрики MeSH
AdultAttitude of Health PersonnelCardiologyCholesterolCholesterol, HDLCholesterol, LDLCohort StudiesEducation, Medical, ContinuingEndocrinologyFamily PracticeFemaleGoalsGuideline AdherenceHealth Knowledge, Attitudes, PracticeHealth Services ResearchHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaInternal MedicineMaleMiddle AgedReference ValuesSurveys and QuestionnairesTriglycerides