Variations in lipid screening frequency in family medicine patients with cardiovascular risk factors.
OBJECTIVE
This study was undertaken to assess the frequency of lipid screening in comparison with the United States Preventive Services Task Force 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 Department of Family Medicine for whom lipid screening was ordered from March to September 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.
Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Yusuf C
YC
Doganer
James E
JE
Rohrer
Kurt B
KB
Angstman
Stephen P
SP
Merry
Jacob L
JL
Erickson
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids / Q000097:blood*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D014481:United States
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D002784:Cholesterol
guidelines; interval; lipid parameters; risk factors; screening