Highlights
- •2013 ACC/AHA cholesterol guideline was controversial and had sub-optimal adherence.
- •We offered case based educational intervention to assess improvement in provider-level knowledge gaps.
- •The intervention was associated with 16–53% absolute improvement in knowledge domain.
- •There was 4–36% improvement in attitude domain.
- •An engaging case based intervention can help in effective dissemination of the cholesterol guideline.
Abstract
Objective
Prior studies have shown provider-level knowledge gaps regarding the 2013 American
College of Cardiology/American Heart Association guideline on the treatment of cholesterol
and concerns about 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation.
The effect of an educational intervention to mitigate knowledge gaps is unknown.
Methods
We developed a questionnaire and administered it to providers before (pre-training)
and after (post-training) a case-based educational intervention across 6 sites in
Texas. The intervention highlighted the key recommendations of the 2013 guideline
and the differences from the prior guideline mainly using clinical-vignettes. Several
practice pertinent items were also discussed.
Results
Most participants were providers-in-training (78%) in internal medicine (68%). Compared
to pre-training, the post-training metrics were: 43% vs. 82% for providers' ability
to identify 4 statin benefit groups; 47% vs. 97% for their awareness of the ASCVD
risk threshold of ≥7.5% to initiate discussion about risks/benefits of statin therapy;
9% vs. 40% for awareness of differences between the Framingham and the ASCVD risk
estimator; 26% vs. 78% for awareness of the definition of statin intensity; 35% vs.
62% for using a repeat lipid panel to document treatment response and adherence; and
46% vs. 81% for confidence in using the ASCVD risk estimator, respectively.
Conclusions
A case-based educational intervention was associated with significant increase in
providers' knowledge towards the 2013 cholesterol guideline, which could be related
to the engaging nature of our intervention, using practice pertinent information and
clinical vignettes. Such interventions could be useful in effective dissemination
of the cholesterol guideline.
Keywords
Abbreviations:
ACC/AHA (American College of Cardiology/American Heart Association), ASCVD (atherosclerotic cardiovascular disease), ATP-III (adult treatment panel III), CHD (coronary heart disease), FH (familial hypercholesterolemia), LDL-C (low-density lipoprotein cholesterol), MI (myocardial infarction)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 06, 2016
Accepted:
December 28,
2015
Received in revised form:
December 17,
2015
Received:
October 20,
2015
Identification
Copyright
Published by Elsevier Inc.
