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

TL;DR

A continuing medical education course improved doctors' confidence and adherence to guidelines for detecting and managing pediatric dyslipidemias in British Columbia.

Contribution

A CME course was developed and shown to effectively increase guideline adherence for pediatric dyslipidemia management.

Findings

The CME course significantly improved the likelihood of screening for FH and confidence in diagnosis.

Adherence to diagnostic and treatment recommendations increased across multiple areas.

93% of participants found the CME course effective for learning new knowledge.

Abstract

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.

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.

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.

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.

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