Barriers to the identification of familial hypercholesterolemia among primary care providers

Familial hypercholesterolemia (FH) is severely underdiagnosed in the USA. Primary care providers are well-positioned to identify FH cases; however, universal FH screening is not routinely implemented in practice. The aim of the present study was to identify perceived barriers to FH screening among p...

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Bibliographic Details
Published in:Journal of community genetics 2019-04, Vol.10 (2), p.229-236
Main Authors: Zimmerman, John, Duprez, Daniel, Veach, Patricia McCarthy, Zierhut, Heather A.
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedicine
Cholesterol
Decision support systems
Epidemiology
Gene Function
Gene Therapy
Human Genetics
Hypercholesterolemia
Original
Original Article
Primary care
Public Health
Questionnaires
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Summary:Familial hypercholesterolemia (FH) is severely underdiagnosed in the USA. Primary care providers are well-positioned to identify FH cases; however, universal FH screening is not routinely implemented in practice. The aim of the present study was to identify perceived barriers to FH screening among primary care physicians in Minnesota. A questionnaire assessed FH screening practices, knowledge, and perceived barriers to FH screening. The questionnaire, sent electronically to internal and family medicine physicians in Minnesota ( N  = 1932) yielded a conservative estimated response rate of 9% ( N  = 173). Although 92% of participants reported themselves responsible for identifying individuals with FH, 30% did not routinely perform screening in practice. Only 50% of participants were able to correctly identify the risk of FH to first-degree relatives of individuals with FH. Challenges incorporating lipid and family history data was the most frequently endorsed barrier to FH screening (34%). A majority of participants endorsed a clinical decision support system that flags individuals at high risk for FH (62%) and an algorithm with cholesterol levels and lipid disorders (56%) as means of facilitating FH screening. Although the generalizability of the findings is unknown, the results underscore the need for increased provider education regarding FH and suggest an FH screening strategy incorporating a clinical decision support system, screening algorithm, and support from other healthcare providers.
ISSN:1868-310X
1868-6001
DOI:10.1007/s12687-018-0383-3