Developing a Knowledge Translation Intervention to Improve the Detection and Management of Pediatric Dyslipidemias in
Venessa K Thorsen1,2,3, Stephanie Glegg3,4, Kevin C Harris1,3
1Children's Heart Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.
Insights
A continuing medical education course improved primary care provider adherence to pediatric dyslipidemia guidelines for familial hypercholesterolemia (FH). The course enhanced screening, diagnosis, and treatment, addressing a critical gap in cardiovascular disease prevention.
Area of Science:
- Cardiology
- Genetics
- Medical Education
Background:
- Familial hypercholesterolemia (FH) is a prevalent genetic disorder linked to early cardiovascular disease.
- Awareness and application of Canadian Cardiovascular Society (CCS)/Canadian Pediatric Cardiology Association (CPCA) guidelines for pediatric dyslipidemia are limited among primary care providers.
- A continuing medical education (CME) course was developed to enhance guideline adherence in British Columbia.
Purpose of the Study:
- To evaluate the effectiveness of a CME course in improving primary care provider adherence to pediatric dyslipidemia guidelines.
- To assess changes in self-reported confidence and clinical practices related to FH screening, diagnosis, and management.
- To identify the most effective methods for guideline dissemination in primary care settings.
Main Methods:
- A quasiexperimental pre-/post-knowledge translation study design was employed.
- The CME course was delivered via in-person and remote formats to family physicians and pediatricians.
- Surveys were administered before and one month after the course to measure changes in knowledge, confidence, and adherence.
Main Results:
- Significant improvements were observed in the likelihood of screening pediatric patients for FH (P < 0.001) and confidence in diagnosis (P < 0.001).
- Adherence to recommendations for screening based on risk factors, diagnostic assessments (e.g., family history, counseling), and treatment (e.g., cascade screening, statin initiation) increased notably.
- Participants reported acquiring new knowledge, with 93% finding the CME format effective for guideline dissemination.
Conclusions:
- The CME course successfully promoted uptake of CCS/CPCA guidelines and improved self-reported clinical practices for pediatric dyslipidemia.
- Expanding the CME course to include trainees, nurses, and pharmacists could further enhance its impact and reach.
- Targeted medical education is a viable strategy to address guideline gaps and improve management of genetic lipid disorders in pediatric populations.
Background:
Familial hypercholesterolemia (FH) is a common, underdiagnosed genetic condition associated with premature cardiovascular disease. Despite the availability of Canadian Cardiovascular Society (CCS)/Canadian Pediatric Cardiology Association (CPCA) guidelines, awareness and uptake among primary care providers remain limited. We developed and evaluated a continuing medical education (CME) course to improve adherence to pediatric dyslipidemia guidelines across British Columbia.
Methods:
We conducted a quasiexperimental pre-/post-knowledge translation study. The CME course was delivered in-person at BC Children's Hospital and remotely to urban and rural family physicians and pediatricians. Pre-course and 1-month post-course surveys assessed self-reported confidence and adherence to CCS/CPCA recommendations.
Results:
Likelihood of screening pediatric patients for FH improved significantly after the course (P < 0.001), as did confidence in screening (P < 0.05) and diagnosing FH (P < 0.001). Screening based on risk factors increased significantly: at-risk race and ethnicity (+41%), cardiometabolic conditions (+51%), early-onset high cholesterol (+46%), family history of diabetes (+26%), and premature cardiovascular events in first-degree relatives (+57%). Adherence to diagnostic recommendations improved, including dietary and exercise counseling (+31%), dietician referral (+29%), family history assessment (+46%), and lipid specialist referral (+36%). Treatment adherence also increased: cascade screening (+14%), statin initiation (+23%), dietician referral (+24%), and lipid specialist referral (+36%). Most participants (93%) agreed or strongly agreed that they acquired new knowledge and found the CME to be the most effective format for guideline dissemination.
Conclusions:
The CME course effectively promoted CCS/CPCA guideline uptake and improved self-reported clinical practices. Expanding delivery to include trainees, nurses, and pharmacists may enhance impact and reach.
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