Studies have shown non-HDL cholesterol to be a more powerful predictor of heart disease risk than the traditional bad cholesterol (LDL or low-density lipoprotein cholesterol) because it includes all forms of bad cholesterol, including LDL cholesterol. Measuring non-HDL cholesterol is also cost-effective because it can be calculated from any standard lipid panel and does not require specialized testing.
But despite these improvements to cholesterol management, the methods have yet to be implemented by most practitioners, says Salim Virani, M.D., a researcher and physician at the Michael E. DeBakey Veterans Affairs (VA) Medical Center.
“Providers are faced with a large number of guidelines to read and implement in clinical practice; the number of these guidelines alone may lead to cognitive overload, and serve as a barrier to effective implementation,” says Virani, who is also affiliated with Baylor College of Medicine. Instead of relying on professional journals or manuals to communicate best practices, he supports more active efforts — such as academic detailing of guidelines by experts, audit and feedback strategies on provider performance, and the use of decision support systems to aid providers in making more evidence-based choices for patient management.
To read more about Virani’s study, read “Have practice guidelines led to optimal management of non-HDL cholesterol?” in the June 2011 newsletter for the James A. Baker III Institute for Public Policy-Baylor College of Medicine Joint Program in Health Policy Research.