Adherence to Pediatric Screening.

Autor: Gauen AM; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA., Wang Y; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA., Perak AM; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA.; Division of Cardiology, Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA.; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA., Davis MM; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA.; Division of Cardiology, Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA.; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA.; Division of Academic General Pediatrics, Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA., Rosenman M; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA., Lloyd-Jones DM; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA., Zmora R; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA., Allen NB; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA., Petito LC; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Nov 05; Vol. 13 (21), pp. e033589. Date of Electronic Publication: 2024 Oct 25.
DOI: 10.1161/JAHA.123.033589
Abstrakt: Background: Preventive screenings in children encourage maintenance of optimal cardiovascular health, but gaps may exist between recommendations and clinical practice. We evaluated adherence to pediatric guidelines for universal age-based and risk-based screening for body mass index, blood pressure, lipids, and blood glucose.
Methods and Results: We used 2010 to 2018 ambulatory visit data from children aged 2 to 12 years within CAPRICORN (Chicago Area Patient-Centered Outcomes Research Network), an electronic health record network in Chicago. This study included 87 549 children who attended 197 559 well-child encounters. Across all encounters, children were 51.5% male and mean (SD) age 6.4 (3.3) years. For each child who attended a well-child visit and met age and/or risk-based criteria, receipt of body mass index, blood pressure, lipids, and/or hemoglobin A1c or fasting blood glucose measurements were assessed. We used generalized estimating equations to calculate proportion adherence for each metric overall and stratified by age, sex, race and ethnicity, and insurance status. Universal age-based screening prevalence (95% CI) per 100 eligible visits was 77.1 (76.8-77.3) for body mass index, 33.4 (33.1-33.7) for blood pressure, and 9.6 (9.3-9.9) for lipids. Risk-based screening prevalence (95% CI) per 100 eligible visits was 13.9 (12.2-15.9) for blood pressure, 6.9 (6.4-7.5) for lipids, and 13.3 (12.6-14.1) for blood glucose.
Conclusions: Early screening of cardiovascular health risk factors could lead to earlier interventions, which could alter cardiovascular health trajectories across the lifetime. Low-to-moderate levels of adherence to universal age-based and risk-based cardiovascular health screening highlight the gap between recommendations and clinical practice, emphasizing the need to understand and address barriers to screening in pediatric populations.
Databáze: MEDLINE
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