Implementation of guideline-based lipid reporting and rate of lipid lowering therapy prescription

Lipid goal attainment remains suboptimal due to patient, provider, and system level factors. We aimed to assess whether updated, guideline-based lipid reporting and clinical decision support was associated with different lipid-lowering therapy (LLT) prescription patterns. We conducted a retrospective study in our electronic health record (EHR) comparing prescriptions within 90 days of lab reporting both prior to the reporting change (21,417 patients in 2019-2020) and after (39,866 patients in 2020-2021). We found a significant increase in the initiation of LLT in patients > 40 years of age with low-density lipoprotein cholesterol (LDL-C) ≥ 100  mg/dL, with 2377 (11.6%) initiated prior to compared to 6205 (16.3%) after the reporting change (P < .001). Among 4469 adult patients with atherosclerotic cardiovascular disease and LDL-C ≥ 70 mg/dL prior to (n = 2040) and after (n = 3277) the reporting change, there was a significantly higher rate of LLT initiation, 444 (25.9%) prior to vs 875 (31.8%) after; P < .001. In conclusion, after implementation of updated guideline-based lipid test reporting, we observed higher initiation rates of LLT for indicated patients. Our study suggests that guideline-based reporting of lipid test results may aid in guideline implementation.