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Variations in lipid screening frequency in family medicine patients with cardiovascular risk factors
Author(s) -
Doganer Yusuf C.,
Rohrer James E.,
Angstman Kurt B.,
Merry Stephen P.,
Erickson Jacob L.
Publication year - 2015
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12290
Subject(s) - medicine , family history , logistic regression , odds ratio , diabetes mellitus , coronary artery disease , guideline , endocrinology , pathology
Rationale, aims and objectives This study was undertaken to assess the frequency of lipid screening in comparison with the U nited S tates P reventive S ervices T ask F orce guideline in a sample of family medicine patients. In addition, we sought to determine the association between testing frequency and achievement of lipid targets. Methods A random sample was extracted from 271 patients from among all patients cared for in our D epartment of F amily M edicine for whom lipid screening was ordered from M arch to S eptember 2012 and who had ≥2 well‐defined cardiovascular risk factors. Lipid testing frequency was classified in three ways: semi‐annual or less often (0–12 tests over 6 years), annual or less often (0–6 tests), or biennial (0–3 tests). Results Multiple logistic regression analysis revealed that the predictors of lipid screening more often than semi‐annually were age ≥60 years [odds ratio ( OR ) = 3.7] and diabetes mellitus ( DM ) ( OR = 30.6). Predictors of screening more often than annually were DM ( OR = 4.3), hypertension ( OR = 2.1), family history of premature coronary artery disease ( OR = 5.6) and statin treatment ( OR = 3.5). Lipid goal attainment was not associated with testing frequency except with regard to low‐density lipoprotein levels ( P = 0.043, P < 0.001, P = 0.005, by semi‐annual, annual and biennial, respectively) and total cholesterol levels ( P = 0.015, P = 0.025 by semi‐annual and annual, respectively). Conclusions Questionable high frequency of lipid testing was detected even when the more conservative approach of annual monitoring was assumed. Frequency of testing was not associated with goal attainment for most parameters. Physicians should request the lipid testing based on overall risk assessment and person variability in accordance with published guidelines.