Case-based educational intervention to assess change in providers' knowledge and attitudes towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management 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 improvements in providers’ knowledge and attitudes 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.

GPs’ familiarity with and use of cardiovascular clinical prediction rules: a UK survey study

“…Electronic databases were searched and 23 studies were found that assessed the familiarity or use of various cardiovascular CPRs: 12 from European countries, 6,[10][11][12][13][14][15][16][17][18][19][20] six from the US, [21][22][23][24][25][26] three from Australia and New Zealand, [27][28][29] and two from other countries. 30,31 These studies showed the familiarity with and use of cardiovascular CPRs varied widely according to specialties and geographic locations.…”

Measurement of Low‐Density Lipoprotein Cholesterol Levels in Primary and Secondary Prevention Patients: Insights From the PALM Registry

“…Recommendations for LDL‐C testing remain in these guidelines to screen for familial hypercholesterolemia, determine response to statin therapy, and assess adherence. Prior studies demonstrated a misconception that clinicians following the 2013 ACC/AHA guidelines no longer needed to measure lipid levels given the shift away from LDL‐C treatment targets 12, 13. Our study showed that many primary and secondary prevention patients were managed without recent LDL‐C testing, which may be a reflection of misinterpretation of the 2013 ACC/AHA guidelines.…”

A dataset to assess providers׳ knowledge and attitudes towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline

“…The tool (dataset) consisted of a questionnaire containing providers׳ demographic information followed by the actual survey questions. There were a total of 23 multiple-choice questions and 2 clinical vignettes [1] , [2] .…”

“… We previously examined provider׳s understanding of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol management guideline (DOI: http://dx.doi.org/10.1016/j.jacl.2015.11.002 )(Virani et al, 2013) [1] , and also assessed whether a case-based educational intervention could improve providers׳ knowledge gaps and attitudes towards the guideline (DOI: 10.1016/j.atherosclerosis.2015.12.044 ) (Pokharel, et al, 2016) [2] . Here we describe the dataset that we used to examine our objectives.…”