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.
J Pediatr. 2014 Mar;164(3):572-6. doi: 10.1016/j.jpeds.2013.10.027. Epub 2013 Nov 16.
To assess the awareness and implementation of lipid guidelines among primary pediatric providers.
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.
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.
These findings underscore the need to further educate providers and supply easily accessible information on the screening and treatment of childhood lipid disorders.
评估初级儿科医生对脂质指南的认知和实施情况。
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。
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。
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。
