Abstract 4359164: A Focus for Improvement - Factors for Lab Adherence in a Pediatric Preventive Cardiology Program

Abstract

Introduction/Background: While many symptoms of cardiovascular disease do not manifest until adulthood, the origins of increased cardiovascular risk can begin during childhood. Children with dyslipidemia are often referred to pediatric preventive cardiology clinics for evaluation. As part of the initial visit and workup, patients are asked to obtain fasting labs before appointments. However, many patients do not obtain their labs which delays appropriate diagnosis and management. This study aimed to determine factors associated with obtaining pre-visit labs in a large academic pediatric preventive cardiology program to ascertain interventions for improvement and implementation. Questions/Hypothesis: We hypothesized that having prior diagnoses associated with cardiovascular risk, being on lipid lowering or antihypertensive medications, or having a family history of cardiovascular disease would be associated with increased odds of obtaining pre-visit labs. Methods/Approach: We conducted a cross-sectional study of new patients to our pediatric preventive cardiology program between 1/2022-2/2025. Demographic, insurance, medication, diagnosis, family history, and visit provider data were collected. Descriptive analyses were performed. Univariable and multivariable logistic regression analyses were performed for factors associated with obtaining pre-visit labs. Results/Data: There were 669 patients included (Table 1 - 48.4% female, mean age 13.8, 62.2% White). 68.3% (454/669) obtained labs before their initial visit. Around half of patients had private health insurance. On univariable logistic regression (Table 2), Black race, “Other” race, and Medicaid insurance type were associated with lower odds of obtaining pre-visit labs (all p<0.05). On multivariable logistic regression, Black race and Medicaid insurance type remained significantly associated with lower odds of obtaining pre-visit labs (both p<0.05). Prior diagnoses, presence of lipid lowering or antihypertensive medication, and family history of cardiac conditions were not associated with obtaining pre-visit labs. Conclusion(s): Social factors like race and insurance status were the strongest drivers for obtaining pre-visit labs in our study. Prior diagnoses, medications, and family history of cardiac conditions did not influence obtaining pre-visit labs. These findings identify potential barriers that can be addressed to improve workup and management of youth with cardiovascular risk conditions.