Nita Chahal, Arnelle Lardizabal, Janet Rush, Christian Delayun, Rayan Rahman, Rita Nobile, Brian W McCrindle
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引用次数: 0
Abstract
Background: Virtual care (VC) in an ambulatory pediatric lipid clinic was rapidly implemented in response to the COVID-19 pandemic, prompting health evaluation and to inform future care planning.
Objective: To assess the impact of VC by analyzing longitudinal changes in lipid profiles and exploring patients' and parents' experiences through surveys and interviews.
Methods: A descriptive, mixed-methods approach examined lipid biomarkers from patients who attended both in-person and VC appointments at a pediatric hospital in Toronto, Canada from 2020 to 2024. This included a retrospective chart review, postpandemic parent survey, and semi-structured interviews. Generalized estimating equations (GEE) were used to model repeated non-high-density lipoprotein (non-HDL) cholesterol levels over time, examining associations with the number of VC visits. The Six-Pillar Framework for VC guided the interview development and qualitative content analysis.
Results: Among the 150 patients (mean age 11 years, SD = 3; 49% female), the trajectory of non-HDL cholesterol levels over time did not significantly differ between those with >3 VC visits and those with fewer visits. However, suboptimal lifestyle behavior patterns were associated with higher non-HDL cholesterol levels. Qualitative data (9 patients, 10 parents) revealed 4 themes: (1) convenient but less effective; (2) managing physical and psychosocial health, (3) situational acceptance, and 4) participant recommendations.
Conclusions: While VC visit frequency alone was not associated with significant changes in non-HDL cholesterol over time, lifestyle factors remained important predictors of lipid outcomes. Recommendations suggested the importance of considering factors such as families' knowledge, privacy, availability of technology, and internet accessibility when planning VC.
期刊介绍：
Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner.
Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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