title: Barriers to non-HDL cholesterol goal attainment by providers.
abstract: OBJECTIVE
  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.
authors.affiliation: Health Policy and Quality Program, Michael E. DeBakey VA Medical Center, Health Services Research and Development Center of Excellence and Section of Health Services Research, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.forename: Lynne
authors.initials: L
authors.lastname: Steinberg
authors.forename: Tyler
authors.initials: T
authors.lastname: Murray
authors.forename: Smita
authors.initials: S
authors.lastname: Negi
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.forename: LeChauncy D
authors.initials: LD
authors.lastname: Woodard
authors.forename: Biykem
authors.initials: B
authors.lastname: Bozkurt
authors.forename: Laura A
authors.initials: LA
authors.lastname: Petersen
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002309:Cardiology / Q000193:education; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D004502:Education, Medical, Continuing; D004704:Endocrinology / Q000193:education; D005194:Family Practice / Q000193:education; D005260:Female; D006040:Goals; D019983:Guideline Adherence / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D007388:Internal Medicine / Q000193:education; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol