Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study
Background: Lipoprotein(a) [Lp(a)] is a low-density lipoprotein variant with atherogenic, thrombogenic, and pro-inflammatory properties that may have numerous pathologic effects, including dyslipidemia. Screening for Lp(a) is clinically significant, due to its causal role in atherosclerotic cardiova...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667724002630 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846138457008635904 |
|---|---|
| author | Wael E. Eid Emma Hatfield Sapp Callen Conroy Coby Bessinger Cassidy L. Moody Ryan Yadav Reece Tolliver Joseph Nolan Suzanne M. Francis |
| author_facet | Wael E. Eid Emma Hatfield Sapp Callen Conroy Coby Bessinger Cassidy L. Moody Ryan Yadav Reece Tolliver Joseph Nolan Suzanne M. Francis |
| author_sort | Wael E. Eid |
| collection | DOAJ |
| description | Background: Lipoprotein(a) [Lp(a)] is a low-density lipoprotein variant with atherogenic, thrombogenic, and pro-inflammatory properties that may have numerous pathologic effects, including dyslipidemia. Screening for Lp(a) is clinically significant, due to its causal role in atherosclerotic cardiovascular disease (ASCVD). Among clinicians, however, there remains a general lack of both clinical awareness of Lp(a) and adequate tools to track Lp(a) testing in patients. Objective: To study factors affecting Lp(a) screening by: i) determining the effectiveness of messaging providers at a large community health system about Lp(a) screening and measuring the subsequent percentage of Lp(a) tests requested; and ii) by determining the percentage of patients who obtained Lp(a) testing after being advised by the provider. Methods: From December 2022 through March 2023, messages detailing the need for Lp(a) screening were sent via the Epic EHR™ to providers of patients meeting criteria for Lp(a) testing in advance of scheduled patient appointments. In this prospective study, providers were randomized into 2 groups: those receiving the pre-appointment message (Group 1) and those not receiving the pre-appointment message (Group 2). Results: Sending pre-appointment messages correlated with more Lp(a) orders (16.6 % v. 4.7 %, P < 0.001) and consequently with more tests performed (10.2 % v. 3.7 %, p < 0.001). Among provider types, nurse practitioners and physician assistants had the highest number of Lp(a) results per order (Z = 16.40, P < 0.001), achieving 30.8–39.1 % more test results, even if they did not receive the pre-appointment message. Distribution of Lp(a) values in patients was 59.7 % ≤ 29 mg/dL; 9.7 % > 29 and < 50mg/dL; and 30.6 % ≥ 50 mg/dL. Conclusion: Providers who received pre-appointment messages via an EHR were associated with requesting more tests and consequently receiving more Lp(a) results, compared with providers who did not receive messages. |
| format | Article |
| id | doaj-art-6d4fb976a33f4d3391b21c05f6422e7f |
| institution | Kabale University |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-6d4fb976a33f4d3391b21c05f6422e7f2024-12-07T08:28:53ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-03-0121100895Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative studyWael E. Eid0Emma Hatfield Sapp1Callen Conroy2Coby Bessinger3Cassidy L. Moody4Ryan Yadav5Reece Tolliver6Joseph Nolan7Suzanne M. Francis8St. Elizabeth Physicians Regional Diabetes Center, Covington, Kentucky, USA; University of Kentucky College of Medicine, Lexington, Kentucky, USA; University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA; University of Alexandria Faculty of Medicine, Egypt; Corresponding author at: 1500 James Simpson, Jr. Way, Covington, KY 41011, United States.St. Elizabeth Healthcare, 20 Medical Village Drive, Suite 103, Edgewood, KY 41017, USAUniversity of Kentucky College of Medicine, 100 Grant Drive Highland Heights, KY, 41076, USAUniversity of Kentucky College of Medicine, 100 Grant Drive Highland Heights, KY, 41076, USAUniversity of Kentucky College of Medicine, 100 Grant Drive Highland Heights, KY, 41076, USAUniversity of Kentucky College of Medicine, 100 Grant Drive Highland Heights, KY, 41076, USANorthern Kentucky University Department of Mathematics and Statistics, Nunn Drive Highland Heights, KY, 41099, USANorthern Kentucky University Department of Mathematics and Statistics, Nunn Drive Highland Heights, KY, 41099, USASt. Elizabeth Healthcare, 20 Medical Village Drive, Suite 103, Edgewood, KY 41017, USABackground: Lipoprotein(a) [Lp(a)] is a low-density lipoprotein variant with atherogenic, thrombogenic, and pro-inflammatory properties that may have numerous pathologic effects, including dyslipidemia. Screening for Lp(a) is clinically significant, due to its causal role in atherosclerotic cardiovascular disease (ASCVD). Among clinicians, however, there remains a general lack of both clinical awareness of Lp(a) and adequate tools to track Lp(a) testing in patients. Objective: To study factors affecting Lp(a) screening by: i) determining the effectiveness of messaging providers at a large community health system about Lp(a) screening and measuring the subsequent percentage of Lp(a) tests requested; and ii) by determining the percentage of patients who obtained Lp(a) testing after being advised by the provider. Methods: From December 2022 through March 2023, messages detailing the need for Lp(a) screening were sent via the Epic EHR™ to providers of patients meeting criteria for Lp(a) testing in advance of scheduled patient appointments. In this prospective study, providers were randomized into 2 groups: those receiving the pre-appointment message (Group 1) and those not receiving the pre-appointment message (Group 2). Results: Sending pre-appointment messages correlated with more Lp(a) orders (16.6 % v. 4.7 %, P < 0.001) and consequently with more tests performed (10.2 % v. 3.7 %, p < 0.001). Among provider types, nurse practitioners and physician assistants had the highest number of Lp(a) results per order (Z = 16.40, P < 0.001), achieving 30.8–39.1 % more test results, even if they did not receive the pre-appointment message. Distribution of Lp(a) values in patients was 59.7 % ≤ 29 mg/dL; 9.7 % > 29 and < 50mg/dL; and 30.6 % ≥ 50 mg/dL. Conclusion: Providers who received pre-appointment messages via an EHR were associated with requesting more tests and consequently receiving more Lp(a) results, compared with providers who did not receive messages.http://www.sciencedirect.com/science/article/pii/S2666667724002630ASCVDatherosclerosisCVD risk screeningcardiovascular diseasecholesterolElectronic Health Record (EHR) |
| spellingShingle | Wael E. Eid Emma Hatfield Sapp Callen Conroy Coby Bessinger Cassidy L. Moody Ryan Yadav Reece Tolliver Joseph Nolan Suzanne M. Francis Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study American Journal of Preventive Cardiology ASCVD atherosclerosis CVD risk screening cardiovascular disease cholesterol Electronic Health Record (EHR) |
| title | Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study |
| title_full | Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study |
| title_fullStr | Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study |
| title_full_unstemmed | Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study |
| title_short | Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study |
| title_sort | increasing provider awareness of lp a testing for patients at risk for cardiovascular disease a comparative study |
| topic | ASCVD atherosclerosis CVD risk screening cardiovascular disease cholesterol Electronic Health Record (EHR) |
| url | http://www.sciencedirect.com/science/article/pii/S2666667724002630 |
| work_keys_str_mv | AT waeleeid increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT emmahatfieldsapp increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT callenconroy increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT cobybessinger increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT cassidylmoody increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT ryanyadav increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT reecetolliver increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT josephnolan increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy AT suzannemfrancis increasingproviderawarenessoflpatestingforpatientsatriskforcardiovasculardiseaseacomparativestudy |