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Study finds repeat lipid testing may be unneeded

Monday July 8, 2013
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An analysis of patients with coronary heart disease who attained low-density lipoprotein cholesterol goals with no treatment intensification suggests that about a third of them underwent repeat testing, according to a report.

The authors noted in the study background that the frequency and correlates of repeat lipid testing in patients with CHD who have achieved Adult Treatment Panel III guideline-recommended LDL-C treatment targets and received no treatment intensification are unknown. The guideline-recommended LDL-C target is less than 100 mg/dL.

"In these patients, repeat lipid testing may represent health resource overuse and possibly waste of healthcare resources," according to the study, which was published July 1 on the website of JAMA Internal Medicine.

Salim S. Virani, MD, PhD, of the Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center of Excellence in Houston, and colleagues analyzed a total of 35,191 patients with CHD in a VA network of seven medical centers.

Of 27,947 patients with LDL-C levels less than 100 mg/dL, 9,200 (32.9%) had additional lipid tests without treatment intensification during the following 11 months, according to the study results.

"Collectively, these 9,200 patients with CHD had a total of 12,686 additional lipid panels performed," the authors wrote. "With a mean lipid panel cost of $16.08 … this is equivalent to $203,990 in annual costs for one VA network and does not take into account the cost of the patient’s time to undergo lipid testing and the cost of the provider’s time to manage these results and notify the patient."

"Our results highlight areas to target for future quality improvement initiatives aimed at reducing redundant lipid testing in patients with CHD.

In a related commentary, Joseph P. Drozda, Jr., MD, of the Mercy Center for Innovative Care in Chesterfield, Mo., wrote: "This well-conceived study on a large clinical database, which has the advantage of containing pharmacy data for use in tracking medication adherence, delivers an important message regarding a type of waste that is likely widespread in healthcare and that goes under the radar because it involves a low-cost test.

"However, it is precisely these low-cost, high-volume tests and procedures that need to be addressed if significant savings from reduction of waste are to be realized."

Read the study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1705724.


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