Adherence Rate of Pediatric Lipid Screening at a Rural, Independently Owned Primary Care and Multispecialty Clinic

In 2011, the AAP endorsed the recommendation of National Heart Lung and Blood Institute (NHLBI) for universal lipid screening in children 9-11 and 17-21 years old given the increasing prevalence of pediatric obesity. In 2017, a study conducted by the AAP showed low adherence with universal pediatric lipid screening. The purpose of this retrospective chart review is to assess the adherence rate for pediatric lipid screening at a rural, independently owned primary care and multispecialty clinic.

Patient data were compiled from the electronic medical record. Inclusion criteria include patients 9-11 or 17-21 years of age between Jan. 1, 2014-Dec. 31, 2019, with an appointment indication of well-child examination or annual physical.

A low percentage of patients underwent a fasting lipid panel in both the 9-11 (n = 663) and 17-21 (n = 118) years age group, 3.3 percent and 4.2 percent respectively. Of those who underwent a fasting lipid panel, 59.0 percent in the 9-11 age group and 80.0 percent in the 17-21 years age group had at least one abnormal lipid level. Of the population classified as overweight and obese, 6.3 percent (16 out of 255) of the 9-11 years age group and 6.1 percent (three out of 49) of the 17-21 years age group underwent a lipid panel screen.

The data show low adherence with universal lipid screening for patients ages 9-11 and 17-21 years old. Poor adherence may be due to inconsistent endorsement by professional medical societies and incongruent recommendations in the EMR. Further studies are required to determine the national adherence rate with the NHLBI recommendation.