Cargando…

Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases

BACKGROUND: Universal lipid screening in children provides an opportunity to mitigate the lifetime risk of atherosclerosis, particularly in children with chronic conditions that are predisposed to early atherosclerosis. In response, national guidelines recommend additional early screening in a subse...

Descripción completa

Detalles Bibliográficos
Autores principales: Berger, Justin H., Faerber, Jennifer A., Chen, Feiyan, Lin, Kimberly Y., Brothers, Julie A., O’Byrne, Michael L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075474/
https://www.ncbi.nlm.nih.gov/pubmed/35301862
http://dx.doi.org/10.1161/JAHA.121.024197
_version_ 1784701693173170176
author Berger, Justin H.
Faerber, Jennifer A.
Chen, Feiyan
Lin, Kimberly Y.
Brothers, Julie A.
O’Byrne, Michael L.
author_facet Berger, Justin H.
Faerber, Jennifer A.
Chen, Feiyan
Lin, Kimberly Y.
Brothers, Julie A.
O’Byrne, Michael L.
author_sort Berger, Justin H.
collection PubMed
description BACKGROUND: Universal lipid screening in children provides an opportunity to mitigate the lifetime risk of atherosclerosis, particularly in children with chronic conditions that are predisposed to early atherosclerosis. In response, national guidelines recommend additional early screening in a subset of cardiac conditions. The penetration of such guidelines has not been evaluated. METHODS AND RESULTS: We performed a retrospective study of a geographically representative sample of US children using the MarketScan Commercial and Medicaid claims databases. The study population was children with cardiac disease between ages 2 and 18 years and ≥3 years of continuous coverage from January 1, 2013, to June 30, 2018, divided into 4 major strata of heart disease. We assessed the likelihood of screening between these classifications and compared with healthy children and calculated multivariate models to identify patient factors associated with screening likelihood. Of the eligible 8.4 million children, 155 000 children had heart disease, of which 1.8% (31 216) had high‐risk conditions. Only 17.5% of healthy children underwent lipid screening. High‐risk children were more likely to be screened (odds ratio [OR], 2.1; 95% CI, 2.09–2.19; P<0.001) than standard‐risk children, but that likelihood varied depending on strata of cardiac disease (22%–77%). Timing of screening also varied, with most occurring between ages 9 and 11 years. Among cardiac conditions, heart transplantation (OR, 16.8; 95% CI, 14.4–19.7) and cardiomyopathy (OR, 2.9; 95% CI, 2.8–3.1) were associated with the highest likelihood of screening. CONCLUSIONS: Children with cardiac disease are more likely to undergo recommended lipid screening than healthy children, but at lower rates and later ages than recommended, highlighting the importance of quality improvement and advocacy for this vulnerable population.
format Online
Article
Text
id pubmed-9075474
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-90754742022-05-10 Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases Berger, Justin H. Faerber, Jennifer A. Chen, Feiyan Lin, Kimberly Y. Brothers, Julie A. O’Byrne, Michael L. J Am Heart Assoc Original Research BACKGROUND: Universal lipid screening in children provides an opportunity to mitigate the lifetime risk of atherosclerosis, particularly in children with chronic conditions that are predisposed to early atherosclerosis. In response, national guidelines recommend additional early screening in a subset of cardiac conditions. The penetration of such guidelines has not been evaluated. METHODS AND RESULTS: We performed a retrospective study of a geographically representative sample of US children using the MarketScan Commercial and Medicaid claims databases. The study population was children with cardiac disease between ages 2 and 18 years and ≥3 years of continuous coverage from January 1, 2013, to June 30, 2018, divided into 4 major strata of heart disease. We assessed the likelihood of screening between these classifications and compared with healthy children and calculated multivariate models to identify patient factors associated with screening likelihood. Of the eligible 8.4 million children, 155 000 children had heart disease, of which 1.8% (31 216) had high‐risk conditions. Only 17.5% of healthy children underwent lipid screening. High‐risk children were more likely to be screened (odds ratio [OR], 2.1; 95% CI, 2.09–2.19; P<0.001) than standard‐risk children, but that likelihood varied depending on strata of cardiac disease (22%–77%). Timing of screening also varied, with most occurring between ages 9 and 11 years. Among cardiac conditions, heart transplantation (OR, 16.8; 95% CI, 14.4–19.7) and cardiomyopathy (OR, 2.9; 95% CI, 2.8–3.1) were associated with the highest likelihood of screening. CONCLUSIONS: Children with cardiac disease are more likely to undergo recommended lipid screening than healthy children, but at lower rates and later ages than recommended, highlighting the importance of quality improvement and advocacy for this vulnerable population. John Wiley and Sons Inc. 2022-03-18 /pmc/articles/PMC9075474/ /pubmed/35301862 http://dx.doi.org/10.1161/JAHA.121.024197 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Berger, Justin H.
Faerber, Jennifer A.
Chen, Feiyan
Lin, Kimberly Y.
Brothers, Julie A.
O’Byrne, Michael L.
Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title_full Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title_fullStr Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title_full_unstemmed Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title_short Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
title_sort adherence with lipid screening guidelines in children with acquired and congenital heart disease: an observational study using data from the marketscan commercial and medicaid databases
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075474/
https://www.ncbi.nlm.nih.gov/pubmed/35301862
http://dx.doi.org/10.1161/JAHA.121.024197
work_keys_str_mv AT bergerjustinh adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases
AT faerberjennifera adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases
AT chenfeiyan adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases
AT linkimberlyy adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases
AT brothersjuliea adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases
AT obyrnemichaell adherencewithlipidscreeningguidelinesinchildrenwithacquiredandcongenitalheartdiseaseanobservationalstudyusingdatafromthemarketscancommercialandmedicaiddatabases