Pediatric Lipid Screening and Treatment in Canada: Practices, Attitudes, and Barriers

The pediatric lipid screening and treatment practices, attitudes, and perceived barriers of Canadian pediatricians are not known. We sought to evaluate this in a survey of pediatricians through the Canadian Pediatric Surveillance Program (CPSP) in March 2019. The survey included an assessment of lipid screening of 9- to 11-year-old youth and a hypothetical case of persistent severe dyslipidemia to ascertain management practices. There were 759 respondents (28% response rate, 759 of 2742), of whom 236 provided outpatient primary care to 9- to 11-year-old youth as part of their routine clinical practice. Among primary care-providing pediatricians, universal lipid screening of healthy 9- to 11-year-old youth most or all of the time was reported by 3% (8 of 230). Reported screening practices most or all of the time were more common for youth with risk factors such as overweight and obesity (54%, 127 of 235) and a family history of premature cardiovascular disease (39%, 85 of 217). Most respondents would refer a child with severe persistent dyslipidemia to dieticians (69%, 152 of 220) and a lipid specialist (64%, 144 of 220) most or all of the time, whereas 7% (16 of 220) would start statin therapy themselves. A lack of Canadian pediatric lipid guidelines was reported as a major barrier for 49% (114 of 233) and minor barrier for 40% (93 of 213). The rate of routine lipid screening of healthy 9- to 11-year-old youth among Canadian primary care-providing pediatricians is low and at odds with current US guidelines. This discrepancy may be due at least in part to a lack of Canadian guidelines on pediatric dyslipidemia, the development of which may address certain perceived barriers and influence future attitudes. On ne sait rien des pratiques de traitement des pédiatres canadiens, ni de leurs positions et des obstacles qu’ils perçoivent au sujet du dépistage des lipides chez les enfants. Pour étudier cette question, un sondage a été réalisé auprès de pédiatres par l’entremise du Programme canadien de surveillance pédiatrique (PCSP) en mars 2019. Le sondage comprenait une évaluation du dépistage des lipides chez les enfants âgés de 9 à 11 ans et des questions au sujet d’un cas hypothétique de dyslipidémie grave persistante, afin de vérifier les stratégies de prise en charge. Au total, 759 pédiatres (taux de réponse de 28 %, soit 759 répondants sur 2742 pédiatres sollicités) ont répondu au sondage; 236 d’entre eux prodiguant des soins primaires à des patients externe