Repeat Lipid Testing Overused in Those Meeting LDL-C Goals
(HealthDay News) – Approximately one-third of patients with coronary heart disease (CHD) who have attained low-density lipoprotein cholesterol (LDL-C) goals undergo repeat lipid assessments, according to a study published online July 1 in JAMA Internal Medicine.
Salim S. Virani, MD, PhD, from the Baylor College of Medicine in Houston, and colleagues assessed the proportion of CHD patients with LDL-C levels of <100mg/dL and no intensification of lipid-lowering therapy who underwent repeat lipid testing.
During an 11-month follow-up period, the researchers found that 32.9% of the 27,947 patients had additional lipid assessments without treatment intensification (12,686 total additional panels; mean, 1.38 additional panel per patient). Repeat testing was significantly more likely for patients with a history of diabetes mellitus (odds ratio [OR], 1.16), a history of hypertension (OR, 1.21), higher illness burden (OR, 1.39), and more frequent primary care visits (OR, 1.32), after adjustment for facility-level clustering. Repeat testing was significantly less likely for patients receiving care at a teaching facility (OR, 0.74) or from a physician provider (OR, 0.93) and for those with a medication possession ratio of 0.8 or higher (OR, 0.75). During follow-up, repeat lipid testing was performed in 62.4% of the 13,114 patients who met the optional LDL-C target level of <70mg/dL.
"Our results highlight areas for quality improvement initiatives to reduce redundant lipid testing," the authors write. "These efforts would be more important if the forthcoming cholesterol guidelines adopt a medication dose-based approach in place of the current treat-to-target approach."
One author disclosed financial ties to the pharmaceutical industry.