Improving Primary Care Screening for Familial Hypercholesterolemia

Background: Familial Hypercholesterolemia (FH) is the most common genetic condition resulting in cardiovascular disease, a leading cause of death in the United States. FH is estimated to affect 1 in 250 individuals with elevated lipid levels present from birth. An estimated 90% of individuals with FH remain undiagnosed. \u27 Purpose: The purpose of this quality improvement project was to increase provider awareness and promote screening for FH among adults ages 20 years and older. \u27 Methods: This quality improvement project consisted of an online educational intervention for providers working at an outpatient clinic regarding FH. Outcomes included: 1) pre-intervention lipid screening practices at the point of admission and every five years; 2) pre-intervention treatment status for clients exceeding the LDL-C 190 mg/dl cut-point; and 3) post-intervention lipid screening practice changes. Assessment of providers\u27 FH knowledge occurred with author created surveys, and a retrospective chart review provided information on documentation of lipid screening practices as well as the proportion of patients screened for FH before and after the educational intervention. Results: Outcome measures of FH knowledge were reported using descriptive statistics. An independent samples t-test showed no statistically significant change in screening practices pre/post-intervention (p = 0.976), with a mean interval of 2.09 years between initial and subsequent testing. Regression analysis yielded a medium correlation effect between age and lipid testing intervals, decreasing by .028 years for every one-year increase in age. The proportion of clinic patients exceeding the expected population estimate for FH was significant (p\u3c.001). Return of clinical impact survey data did not occur. Conclusions: Electronic Medical Record data identified undiagnosed patients in the clinic population at risk for FH. Knowledge surveys identified themes for further provider FH education.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1000/thumbnail.jp