The following is a summary of “Racial Disparities in Lipid Screening Among Patients With Coronary Artery Disease Narrowed in Primary Care Settings Supportive of Nurse Practitioners,” published in the October 2023 issue of Primary Care by Brom et al.

Coronary artery disease (CAD) is the predominant heart condition in the United States, showing a disproportionate impact on Black individuals in comparison to their White counterparts. Regular primary care visits and consistent dyslipidemia screening are pivotal in ensuring optimal care for CAD patients. As nurse practitioners (NPs) increasingly take on primary care responsibilities, their practice environments could affect their ability to deliver these essential services.

The objective of this study was to investigate potential disparities in lipid screening rates among Black and White patients diagnosed with CAD about the scores reflecting the NP practice environment.

To achieve this, cross-sectional survey data from nurse practitioners working within primary care practices were linked with Medicare claims to analyze outcomes in a cohort of 111,911 CAD patients. These 94% White and 6% Black patients were drawn from 456 primary care practices across California, Florida, New Jersey, and Pennsylvania in 2016. The NP-Primary Care Organizational Climate Questionnaire, designed to gauge the level of supportiveness in a practitioner’s workplace, was the tool to assess the NP practice environment. Utilizing multilevel regression models that accounted for various patient and practice characteristics, the study aimed to explore the correlation between the NP practice environment scores and lipid screening rates among Black and White CAD patients.

Findings revealed notable differences in the frequency of annual lipid screening between White and Black patients diagnosed with CAD, with a lower rate among Black patients (77.0% vs. 70.6%; p < .001). The study observed a noteworthy association after conducting logistic regression models that adjusted for patient and practice-related factors. For every standard deviation increase in the practice environment score, Black patients experienced a 5% rise in the likelihood of receiving lipid screening, pointing to a potential impact of the NP practice environment on reducing disparities in screening rates among CAD patients of different racial backgrounds.

Source: sciencedirect.com/science/article/abs/pii/S2155825623001102