Developing a Knowledge Translation Intervention to Improve the Detection and Management of Pediatric Dyslipidemias in British Columbia

Abstract

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.