Non-high-density lipoprotein cholesterol calculation and goal awareness among physicians-in-training

Authors

Smita I. Negi, Baylor College of Medicine, United States
Lynne Steinberg, University of Houston, United States
Venkateshwar R. Polsani, Tulane Heart and Vascular Center, United States
Saqib A. Gowani, University of Connecticut, United States
Vijay Nambi, Baylor College of Medicine, United States
Varinder Kumar, University of Vermont, United States
Victor Marinescu, William Beaumont Hospital, United States
Peter H. Jones, Baylor College of Medicine, United States
Laura A. Petersen, Baylor College of Medicine, United States
Salim S. Virani, Baylor College of Medicine, United StatesFollow

Document Type

Article

Department

Cardiology

Abstract

Background: Non-high density lipoprotein cholesterol (non-HDL-C) goal attainment per Adult Treatment Panel III (ATP III) guidelines remains low.
Objective: To understand gaps in knowledge and practices of physicians-in-training (internal medicine, family medicine, cardiology, endocrinology) towards non-HDL-C.
Methods: A survey based on a conceptual model to assess the trainee's knowledge, attitudes, and practice regarding non-HDL-C was developed and administered to physicians-in-training (n = 655) at 26 training programs in the United States. Responses of those in internal medicine and family medicine (residents-in-training; n = 418) were compared with those in cardiology and endocrinology (fellows-in-training; n = 124).
Results: Response rate was 83.7%. Fifty-three percent of residents and 31% of fellows-in-training had not read the ATP III guidelines (P < .001). Thirty-three percent of the residents and 35% fellows-in-training could not calculate non-HDL-C from a standard lipid panel (P = .7). Sixty-seven percent of the residents and 52% of fellows were not aware of treatment goals for non-HDL-C (P = .004 for comparison between residents and fellows). Both residents and fellows reported infrequent calculation of non-HDL-C levels in patients with elevated triglycerides (≥200 mg/dL; 32.5% vs 35.4%, respectively, P = .6). Lack of familiarity with ATP III guidelines, lack of knowledge regarding importance of non-HDL-C, lack of institutional mandate to calculate non-HDL-C, and lack of emphasis on non-HDL-C by teaching staff were reported as barriers to non-HDL-C use in routine clinical practice.
Conclusions: At least one-third of physicians-in-training could not calculate non-HDL-C from a standard lipid panel, and a large number were not aware of ATP III treatment goals pertaining to non-HDL-C. This area represents one for improvement if non-HDL-C is to be retained as a treatment target in the forthcoming ATP-IV guidelines.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Journal of Clinical Lipidology

Recommended Citation

Negi, S. I., Steinberg, L., Polsani, V. R., Gowani, S. A., Nambi, V., Kumar, V., Marinescu, V., Jones, P. H., Petersen, L. A., Virani, S. S. (2012). Non-high-density lipoprotein cholesterol calculation and goal awareness among physicians-in-training. Journal of Clinical Lipidology, 6(1), 50-57.
Available at: https://ecommons.aku.edu/provost_office/264