Primary Care Interventions to Increase Lifestyle Modification Education for Hyperlipidemia Patients

Abstract

Purpose: This Quality Improvement Project aimed to enhance lifestyle and dietary education for patients with hyperlipidemia at Benson Family Health Center through provision of take-home educational handouts and dietician referrals. Background: Hyperlipidemia significantly contributes to prevalence of heart disease and stroke, which are the leading and fifth leading causes of death in United States, respectively (Centers for Disease Control and Prevention [CDC], 2023). Approximately 86 million American adults over 20 years old have cholesterol levels exceeding 200 mg/dL, yet less than half receive appropriate treatment (CDC, 2023). Alarmingly, about 10% of adults have cholesterol levels above 240 mg/dL, 17% have HDL (high-density lipoprotein) levels under 40 mg/dL (CDC, 2023). However, studies have shown that behavior modification, including dietary changes, medication, exercise, and comprehensive risk factor management, can potentially slow, stop, or reverse atherosclerotic cardiovascular disease progression (Franklin, 2020). Methods: This quality improvement project utilized four Plan-Do-Study-Act (PDSA) cycles over four weeks. Following institutional review board (IRB) approval, baseline data were collected through chart audits, which revealed a significant gap in care. Audits revealed no hyperlipidemia patients received any educational materials during their visit, only 10% were referred to dietitian, highlighting need for resources and standardized referral practices. Intervention used during this project comprised: (1) implementation of standardized American Heart Association educational materials, (2) systematic documentation protocols for lifestyle counseling, and (3) streamlined dietician referral processes. Data collection occurred through weekly chart audits at conclusion of each PDSA cycle. Outcome measures included frequency of handout distribution, documentation rates of lifestyle education, and frequency of dietician referrals. Pre and post-surveys were completed by single APRN participant to assess for practice changes upon completion of implementation. Results: There was a significant increase in frequency of lifestyle and behavioral education and documentation of education given to patients with hyperlipidemia after implementing standardized educational pamphlets into practice. Frequency of education and documentation increased from 40% to 72% after PDSA cycles over one month. Additionally, there was a modest increase in dietary referrals from 10% to 12% over one-month intervention. Conclusions: This initiative effectively increased education and documentation of non-pharmacological interventions related to hyperlipidemia, promoting healthier lifestyle choices with goal of improving overall health outcomes for BFHC patients. Further education is needed to explore long-term impact that providing these educational handouts on patient outcomes related to hyperlipidemia and cardiovascular health.