title: Proportion of adults fasting for lipid testing relative to guideline changes in Alberta.
abstract: BACKGROUND
  Guidelines have historically recommended measuring lipid profile tests in a fasting state. However, in April 2011 and 2014, the Canadian city of Calgary and its province of Alberta, respectively, have changed their lipid guidelines to allow testing for individuals in any fasting state; several years prior to the release of the 2016 Canadian Cardiovascular Society and Hypertension Canada guidelines. The purpose of this study was to document the proportion of individuals in Calgary who fasted for a lipid encounter in relation to the change in various guidelines and policies.
  
  
  METHODS
  Counts were collected each month per gender from January 1, 2010 to June 30, 2016 for community-based adults ≥18years old who fasted (≥8h) or did not fast (<8h) for a lipid encounter.
  
  
  RESULTS
  During the study period, 793,719 community-based lipid profiles were performed, 590,174 in a fasting state. The proportion of adults who fasted declined from 98.59%±0.379% (mean±SD) in 2010 to 41.65%±1.295% (mean±SD) in 2016. However, a marked decline in the proportion of adults fasting for a lipid encounter was not observed until February 2015, which coincided with the release of Alberta's Toward Optimized Practice Clinical Practice Guidelines.
  
  
  CONCLUSIONS
  This documentation of individuals fasting for a lipid encounter may assist other jurisdictions in Canada with the new nonfasting lipid guideline changes. We recommend releasing provincial clinical practice guidelines, in addition to laboratory bulletins and continuing medical education presentations, regarding the new nonfasting lipid recommendations in other jurisdictions to ensure community patients are aware of this change.
authors.affiliation: Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Canada.
authors.forename: Irene
authors.initials: I
authors.lastname: Ma
authors.affiliation: Calgary Laboratory Services, Calgary, Alberta, Canada.
authors.forename: Jeannine
authors.initials: J
authors.lastname: Viczko
authors.affiliation: Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Canada; Family Medicine, Cumming School of Medicine, University of Calgary, Canada; Calgary Laboratory Services, Calgary, Alberta, Canada. Electronic address: Christopher.Naugler@cls.ab.ca.
authors.forename: Christopher
authors.initials: C
authors.lastname: Naugler
mesh_terms: D000328:Adult; D000416:Alberta / Q000453:epidemiology; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology*; D005215:Fasting / Q000502:physiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*
chemical_list: D008055:Lipids
keywords: Fasting; Laboratory medicine; Lipid testing; Nonfasting guidelines