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儿科初级保健提供者在儿童中实施血脂筛查指南。

Implementation of lipid screening guidelines in children by primary pediatric providers.

机构信息

Division of Cardiology, Department of Pediatrics, University of Minnesota, Minneapolis, MN.

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.

出版信息

J Pediatr. 2014 Mar;164(3):572-6. doi: 10.1016/j.jpeds.2013.10.027. Epub 2013 Nov 16.

Abstract

OBJECTIVE

To assess the awareness and implementation of lipid guidelines among primary pediatric providers.

STUDY DESIGN

An online survey was administered to primary pediatric providers (n = 1488): pediatricians, family medicine/general practitioners, and advanced practitioners (nurse practitioners/physician assistants) in Minnesota. The survey was conducted over 12 weeks in 2012-2013. A multiple-choice questionnaire was used to evaluate the participants' knowledge, screening, and management attitudes regarding pediatric lipid guidelines.

RESULTS

The overall response rate was 39% (n = 548 of 1402 successful e-mails). Respondents were primarily pediatricians and family medicine practitioners (37% each), followed by general practitioners (11%) and advanced practitioners (nurse practitioners, 5.5%; physician assistants, 1.6%). Although 74% of providers reportedly believed that lipid screening and treatment would reduce future cardiovascular risk, 34% performed no screening, 50% screened selectively, and only 16% performed universal screening. Pediatricians were more likely to screen, with 30% performing universal screening and 41% performing selective screening. Among perceived barriers to screening, providers reported uneasiness addressing lipid disorders (43%), and unfamiliarity with screening guidelines (31%). The majority (83%) were uncomfortable managing lipid disorders, and 57% were opposed to the use of lipid-lowering medications in children.

CONCLUSION

These findings underscore the need to further educate providers and supply easily accessible information on the screening and treatment of childhood lipid disorders.

摘要

目的

评估初级儿科医生对脂质指南的认知和实施情况。

研究设计

对明尼苏达州的初级儿科医生(儿科医生、家庭医学/全科医生和高级从业者(护士从业者/医师助理))进行了一项在线调查(n = 1488)。该调查于 2012 年至 2013 年期间进行了 12 周。使用多项选择题问卷评估参与者对儿科脂质指南的知识、筛查和管理态度。

结果

总体回复率为 39%(n = 548/1402 成功发送的电子邮件)。受访者主要是儿科医生和家庭医学从业者(各占 37%),其次是全科医生(11%)和高级从业者(护士从业者,5.5%;医师助理,1.6%)。尽管 74%的提供者表示相信脂质筛查和治疗可以降低未来的心血管风险,但 34%的人没有进行筛查,50%的人选择性地进行筛查,只有 16%的人进行了普遍筛查。儿科医生更有可能进行筛查,其中 30%的人进行了普遍筛查,41%的人进行了选择性筛查。在被认为是筛查的障碍中,提供者报告处理脂质紊乱感到不安(43%),不熟悉筛查指南(31%)。大多数(83%)对管理脂质紊乱感到不舒服,57%的人反对在儿童中使用降脂药物。

结论

这些发现强调了需要进一步教育提供者,并提供有关儿童脂质紊乱筛查和治疗的易于访问的信息。

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