Lipoprotein(a) testing in an outpatient cardiology clinic: A quality improvement initiative

BACKGROUND Elevated lipoprotein(a) Lp(a) is an independent and causal risk factor for atherosclerotic cardiovascular disease. Increasingly, prevention societies recommend testing Lp(a) at least once for all adults. OBJECTIVE A quality improvement (QI) initiative aimed to increase the rates of Lp(a) ordering for patients was piloted in the general cardiology fellows' clinic at an urban academic medical center. METHODS QI project interventions focused on provider education and inclusion of electronic health record-based tools. RESULTS Over a period of 10 months, the proportion of patients with an Lp(a) order increased from 10.1% to 20.9%, and the proportion of patients with an Lp(a) result increased from 7.0% to 11.2%. CONCLUSION Ahead of results from ongoing clinical trials testing Lp(a)-targeted therapies, health systems can use QI methods to assess current Lp(a) ordering practices, identify patients who may benefit from future Lp(a)-targeted therapy, and plan for rapid expansion of Lp(a) testing.