{"title":"脂蛋白(a)发现项目:为国民教育确定脂蛋白(a)检测意识和模式的倡议","authors":"","doi":"10.1016/j.jacl.2024.04.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Study Funding</h3><p>Novartis is proud to support the American Heart Association's Lp(a) Discovery Project.</p></div><div><h3>Background/Synopsis</h3><p>It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease even in the setting of effective reduction of plasma low-density lipoprotein cholesterol. Race and ethnicity also play a role in Lp(a) regulation. There are currently no standard management approaches for diagnosis or risk assessment, nor any targeted treatments available to lower Lp(a).</p></div><div><h3>Objective/Purpose</h3><p>The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients tested for elevated Lp(a). We aim to improve the number of patients tested for Lp(a) by improving processes and workflows across care settings through dissemination of national testing models.</p></div><div><h3>Methods</h3><p>The AHA has engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model called an Expert Forum. The health systems share best practices and inform on models for Lp(a) testing. Virtual, monthly AHA-led consultant interviews with the health systems are used to document existing provider and health system level Lp(a) testing processes, resources, and barriers. Findings are presented quarterly during virtual Expert Forum meetings, with all participating health systems, to come to consensus on models for national dissemination. Professional education topics identified during these calls are explored to build awareness for the importance of Lp(a) testing. Data on testing rates will be collected through the AHA's Get With The Guidelines (GWTG)-Stroke and GWTG-Coronary Artery Disease modules.</p></div><div><h3>Results</h3><p>From consultations, AHA found that Lp(a) testing awareness for providers and patients varies. There is inconsistent provider knowledge about the importance of Lp(a) testing for a patient's overall cardiovascular risk profile. Providers are sometimes reluctant to order an Lp(a) test because of lack of awareness of next steps for patients with elevated Lp(a), such as intensive management of other risk factors. There is also a need to educate providers on how to talk with their patients about Lp(a) testing and cascade testing for family members for those who have elevated Lp(a).</p></div><div><h3>Conclusions</h3><p>Improving provider and patient awareness of the importance of Lp(a) testing is critical to improving patient care. The Lp(a) Discovery Project is identifying gaps in patient and professional education for Lp(a), barriers to streamlined testing, and implementing strategies to improve national Lp(a) testing rates through professional education and patient resources.</p></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lipoprotein (a) Discovery Project: Initiative to Identify Awareness and Models of Lipoprotein (a) Testing for National Education\",\"authors\":\"\",\"doi\":\"10.1016/j.jacl.2024.04.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Study Funding</h3><p>Novartis is proud to support the American Heart Association's Lp(a) Discovery Project.</p></div><div><h3>Background/Synopsis</h3><p>It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease even in the setting of effective reduction of plasma low-density lipoprotein cholesterol. Race and ethnicity also play a role in Lp(a) regulation. There are currently no standard management approaches for diagnosis or risk assessment, nor any targeted treatments available to lower Lp(a).</p></div><div><h3>Objective/Purpose</h3><p>The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients tested for elevated Lp(a). We aim to improve the number of patients tested for Lp(a) by improving processes and workflows across care settings through dissemination of national testing models.</p></div><div><h3>Methods</h3><p>The AHA has engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model called an Expert Forum. The health systems share best practices and inform on models for Lp(a) testing. Virtual, monthly AHA-led consultant interviews with the health systems are used to document existing provider and health system level Lp(a) testing processes, resources, and barriers. Findings are presented quarterly during virtual Expert Forum meetings, with all participating health systems, to come to consensus on models for national dissemination. Professional education topics identified during these calls are explored to build awareness for the importance of Lp(a) testing. Data on testing rates will be collected through the AHA's Get With The Guidelines (GWTG)-Stroke and GWTG-Coronary Artery Disease modules.</p></div><div><h3>Results</h3><p>From consultations, AHA found that Lp(a) testing awareness for providers and patients varies. There is inconsistent provider knowledge about the importance of Lp(a) testing for a patient's overall cardiovascular risk profile. Providers are sometimes reluctant to order an Lp(a) test because of lack of awareness of next steps for patients with elevated Lp(a), such as intensive management of other risk factors. There is also a need to educate providers on how to talk with their patients about Lp(a) testing and cascade testing for family members for those who have elevated Lp(a).</p></div><div><h3>Conclusions</h3><p>Improving provider and patient awareness of the importance of Lp(a) testing is critical to improving patient care. The Lp(a) Discovery Project is identifying gaps in patient and professional education for Lp(a), barriers to streamlined testing, and implementing strategies to improve national Lp(a) testing rates through professional education and patient resources.</p></div>\",\"PeriodicalId\":15392,\"journal\":{\"name\":\"Journal of clinical lipidology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of clinical lipidology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1933287424000576\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical lipidology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1933287424000576","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
摘要
研究经费诺华很荣幸能为美国心脏协会的脂蛋白(a)发现项目提供支持。背景/简介据估计,每 5 个美国人中就有 1 个脂蛋白 (a) [Lp(a)] 含量过高。即使在有效降低血浆低密度脂蛋白胆固醇的情况下,高水平的脂蛋白(a)也是动脉粥样硬化性心血管疾病的一个独立的、主要是遗传性的因果危险因素。种族和人种在 Lp(a) 的调节中也发挥着作用。目前还没有标准的诊断或风险评估管理方法,也没有降低脂蛋白(a)的靶向治疗方法。目标/目的美国心脏协会(AHA)正在全国范围内实施一项为期 3 年的名为 "脂蛋白(a)发现项目 "的计划,以了解系统层面上检测脂蛋白(a)升高患者的实践模式。我们的目标是通过推广全国性的检测模式,改善各医疗机构的流程和工作流程,从而增加接受脂蛋白(a)检测的患者人数。方法美国心脏协会已邀请 10 位来自不同医疗系统、拥有成熟脂蛋白(a)筛查流程和工作流程的倡导者参加一个名为 "专家论坛 "的学习型医疗系统模式。这些医疗系统分享最佳实践,并就脂蛋白(a)检测模式提供信息。由 AHA 领导的顾问每月与医疗系统进行虚拟访谈,记录现有的医疗服务提供者和医疗系统水平的脂蛋白(a)检测流程、资源和障碍。调查结果每季度在虚拟专家论坛会议上与所有参与的医疗系统进行交流,以便就在全国推广的模式达成共识。在这些电话会议中确定的专业教育主题将得到探讨,以建立对脂蛋白(a)检测重要性的认识。有关检测率的数据将通过 AHA 的 "Get With The Guidelines (GWTG)--脑卒中 "和 "GWTG--冠状动脉疾病 "模块收集。医疗服务提供者对脂蛋白(a)检测对患者整体心血管风险状况的重要性认识不一。医疗服务提供者有时不愿意要求进行脂蛋白(a)检测,因为他们不了解脂蛋白(a)升高患者的下一步治疗措施,如加强对其他危险因素的管理。此外,还需要教育医疗服务提供者如何与患者谈论脂蛋白(a)检测,以及如何对脂蛋白(a)升高患者的家庭成员进行逐级检测。结论提高医疗服务提供者和患者对脂蛋白(a)检测重要性的认识对于改善患者护理至关重要。脂蛋白(a)发现项目正在确定患者和专业人员在脂蛋白(a)教育方面的差距、简化检测的障碍,并通过专业教育和患者资源实施提高全国脂蛋白(a)检测率的战略。
Lipoprotein (a) Discovery Project: Initiative to Identify Awareness and Models of Lipoprotein (a) Testing for National Education
Study Funding
Novartis is proud to support the American Heart Association's Lp(a) Discovery Project.
Background/Synopsis
It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease even in the setting of effective reduction of plasma low-density lipoprotein cholesterol. Race and ethnicity also play a role in Lp(a) regulation. There are currently no standard management approaches for diagnosis or risk assessment, nor any targeted treatments available to lower Lp(a).
Objective/Purpose
The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients tested for elevated Lp(a). We aim to improve the number of patients tested for Lp(a) by improving processes and workflows across care settings through dissemination of national testing models.
Methods
The AHA has engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model called an Expert Forum. The health systems share best practices and inform on models for Lp(a) testing. Virtual, monthly AHA-led consultant interviews with the health systems are used to document existing provider and health system level Lp(a) testing processes, resources, and barriers. Findings are presented quarterly during virtual Expert Forum meetings, with all participating health systems, to come to consensus on models for national dissemination. Professional education topics identified during these calls are explored to build awareness for the importance of Lp(a) testing. Data on testing rates will be collected through the AHA's Get With The Guidelines (GWTG)-Stroke and GWTG-Coronary Artery Disease modules.
Results
From consultations, AHA found that Lp(a) testing awareness for providers and patients varies. There is inconsistent provider knowledge about the importance of Lp(a) testing for a patient's overall cardiovascular risk profile. Providers are sometimes reluctant to order an Lp(a) test because of lack of awareness of next steps for patients with elevated Lp(a), such as intensive management of other risk factors. There is also a need to educate providers on how to talk with their patients about Lp(a) testing and cascade testing for family members for those who have elevated Lp(a).
Conclusions
Improving provider and patient awareness of the importance of Lp(a) testing is critical to improving patient care. The Lp(a) Discovery Project is identifying gaps in patient and professional education for Lp(a), barriers to streamlined testing, and implementing strategies to improve national Lp(a) testing rates through professional education and patient resources.
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. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal 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.