Identification of Undiagnosed Hyperlipidemia: Do Work Site Screening Programs Work?
OBJECTIVE
We evaluated the rate of hyperlipidemia identified during workplace screening in previously undiagnosed individuals, the association between workplace hyperlipidemia screening and use of medical care during follow-up, and changes in lipid profile among individuals with hyperlipidemia at screening.


METHODS
Nonexperimental longitudinal study.


METHODS
Employees who participated in a workplace health screening.


METHODS
A total of 18 993 individuals from 39 self-insured employers in the United States.


METHODS
Total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides were measured during screening. A claims-based algorithm was used to identify hyperlipidemia cases.


METHODS
Discrete-time survival analysis was used to estimate monthly rates of new hyperlipidemia diagnoses or prescriptions. Paired t tests were used to evaluate 1-year changes in lipid profile.


RESULTS
A total of 1872 (9.9%) individuals had hyperlipidemia at screening. Among all individuals, a significantly greater rate of new hyperlipidemia diagnoses was observed during the first month after screening, compared to the 3 months before screening (odds ratio [95% CI]: 2.99 [2.66-3.36]). Among the 987 individuals who were followed up 1 year later, significant improvements were observed in total cholesterol (-8.5% ± 13.6%) and LDL levels (-10.2% ± 19.3%).


CONCLUSIONS
Workplace health screenings in an insured population were associated with a subsequent increase in physician visits and prescriptions for hyperlipidemia. After 1 year, significant improvements in total cholesterol and LDL levels were observed among individuals who screened positive for hyperlipidemia.
1 Health Advocate, Westlake Village, CA, USA.
Alain K
AK
Koyama
2 West, Westlake Village, CA, USA.
Vishal
V
Bali
2 West, Westlake Village, CA, USA.
Irina
I
Yermilov
3 Department of Health Policy and Management, University of California Fielding School of Public Health, Los Angeles, CA, USA.
Antonio P
AP
Legorreta
D000328:Adult; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000175:diagnosis*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009786:Occupational Health Services / Q000379:methods*; D015397:Program Evaluation; D014280:Triglycerides / Q000097:blood; D017132:Workplace
D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D002784:Cholesterol
hyperlipidemias; population health; prevention research; screening; workplace