Barriers to non-HDL cholesterol goal attainment by providers

Salim S. Virani, Lynne Steinberg, Tyler Murray, Smita Negi, Vijay Nambi, Lechauncy D. Woodard, Biykem Bozkurt, Laura A. Petersen, Christie M. Ballantyne

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)876-880.e2
JournalAmerican Journal of Medicine
Issue number9
Publication statusPublished - Sept 2011
Externally publishedYes


  • Adult Treatment Panel III guidelines
  • Guideline adherence
  • Non-HDL cholesterol
  • Provider knowledge
  • Treatment practice


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