Unnecessary Cholesterol Tests

A new study suggests that many U.S. patients with heart problems may be getting unnecessary cholesterol tests.

About one in every six adult Americans has high blood cholesterol, putting them at risk of heart disease, according to the U.S. Centers for Disease Control and Prevention.

In a Houston-based Veteran’s Affairs network, statistics on more than 35,oo patients with coronary heart disease treated there suggest this is an area of over-testing, such as unnecessary cholesterol tests, that are contributing to the nation’s increasing medical costs. The study also found that at this one network of seven hospitals, the cost of redundant and unnecessary cholesterol tests amounted to more than $200,00 in one year.

“These results represent health care resource overuse and possibly their waste,” said lead researcher Dr. Salim Virani, a cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

On July 1st the study was published in JAMA Internal Medicine, the study focused on almost 28,000 patients that were taking statin drugs to keep their cholesterol levels normal, less than 100 milligrams of cholesterol per deciliter of blood. The researchers discovered that in an 11-month period repeat tests were ordered for one-third of the patients even though their medication had not changed. Most of the patients who had repeat testing or unnecessary cholesterol tests, had a history of diabetes, high blood pressure and visited the doctor more often; authors noted that the extra tests probably gave the patients a measure of comfort.

“Apart from the costs associated with these lipid panels, this also carries with it the cost for the patient’s time to undergo a repeat blood test and cost for the health care provider’s time to follow up on these results after redundant testing and to inform the patient about these results,” said Virani.

Although not all experts agreed with the results the study found.

Dr. Gregg Fonarow, professor of cardiology at the University of California, Los Angeles and a spokesman for the American Heart Association said that current national guidelines recommend that patients with coronary heart disease have their cholesterol checked every four to six months. He stated that the study showed a pattern of lipid testing that is consistent with the guidelines.

Dr. Joseph Drozda Jr., author of an accompanying journal editorial, said that “seemingly inexpensive tests” really add up when done in large numbers. Drozda thinks this is one of the many examples of not only unnecessary cholesterol tests, but of many more tests. “A lot of tests are ordered without direct benefit to the patient and result in this kind of waste,” said Drozda.

“We need to be looking for all of these sources of waste and addressing them,” he added.


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