The impact of electronic health messaging on diagnosis of familial hypercholesterolemia and management of patients with LDL-C ≥190 mg/dL
Year: 2025
Type: article
Abstract: BACKGROUND: Patients with elevated low-density lipoprotein-cholesterol (LDL-C) are at higher risk for atherosclerotic cardiovascular disease (ASCVD) and are often undertreated with lipid-lowering therapies (LLT). The impact of electronic health record (EHR) messaging on improving diagnosis and management remains unclear. OBJECTIVE: We implemented a best practice advisory (BPA) alert for physicians prompted by an LDL-C ≥190 mg/dL in their patients, recommending evaluation for familial hypercholesterolemia (FH) with appropriate guideline-directed treatment. METHODS: Data on patients with BPAs triggered from August 2021 to June 2024, and with at least 3 months follow-up, were analyzed for changes in diagnoses, medication use, and lipid levels. RESULTS: Among 665 patients (mean age 58 years, 55% female, 29% Hispanic, and 28% Asian), FH diagnoses (limited to ICD-10 and SNOMED codes) increased from 2.3% to 6%. Statin use rose from 39.4% to 61.7% (P < .0001), with high-intensity statins from 22.9% to 39.0% (P < .0001). LDL-C declined from before to after the BPA alert (adjusted mean change -84.1 mg/dL, P < .0001). CONCLUSION: BPA alerts for patients with LDL-C ≥ 190 mg/dL improve diagnosis rates for hyperlipidemia and FH, increase LLT use, and reduce LDL-C levels.
Source: Journal of clinical lipidology
Authors: Yihang Fan, Lingling Li, Wenjun Fan, Jing Gu, Robert J. Sanchez, Nathan D. Wong
Institutions: University of California, Irvine, Regeneron (United States)
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,510
OpenAlex ID: W4415828292