TY - JOUR
T1 - Barriers to non-HDL cholesterol goal attainment by providers
AU - Virani, Salim S.
AU - Steinberg, Lynne
AU - Murray, Tyler
AU - Negi, Smita
AU - Nambi, Vijay
AU - Woodard, Lechauncy D.
AU - Bozkurt, Biykem
AU - Petersen, Laura A.
AU - Ballantyne, Christie M.
N1 - Funding Information:
Funding: This work was supported by Investigator Initiated Research funding by Merck and Co., Inc. (II SP 37267), as well as the Houston VA Health Services Research & Development Center of Excellence (Grant no. HFP90-020 ). Dr. Virani is supported by a Department of Veterans Affairs Health Services Research and Development Service (HSR&D) Career Development Award (Grant no. CDA 09-028 ). This work also was supported in part by VA HSR&D IIR 04-349 (PI Laura A. Petersen, MD, MPH) and National Institutes of Health R01 HL079173-01 (PI Laura A. Petersen, MD, MPH). Dr. Petersen was a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar (Grant no. 045444 ) and an American Heart Association Established Investigator Awardee (Grant no. 0540043N ) at the time this work was conducted. The funding sources played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
PY - 2011/9
Y1 - 2011/9
N2 - 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.
AB - 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.
KW - Adult Treatment Panel III guidelines
KW - Guideline adherence
KW - Non-HDL cholesterol
KW - Provider knowledge
KW - Treatment practice
UR - http://www.scopus.com/inward/record.url?scp=80052015023&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2011.02.012
DO - 10.1016/j.amjmed.2011.02.012
M3 - Article
AN - SCOPUS:80052015023
SN - 0002-9343
VL - 124
SP - 876-880.e2
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 9
ER -