141 clinical laboratories were invited to participate from diverse regions across Spain. We obtained the number of serum cholesterol, high-density cholesterol (HDL-cholesterol) and triglycerides requested by General Practitioners for the year 2012. Two types of appropriateness indicators were calculated: test requests per 1000 inhabitants and ratio of related tests requests (HDL-cholesterol/cholesterol, triglycerides /cholesterol). The indicators results obtained in different setting, with different type of management and in different geographical areas were compared.
We obtained production statistics from 76 laboratories who attended a population of 17,679,195 inhabitants from 13 Communities throughout Spain. 5,823,053 cholesterol, 4,544,663 HDL-cholesterol and 5,599,358 triglycerides tests were ordered. Cholesterol, HDL-cholesterol and triglycerides per 1000 inhabitants indicators results ranged from 106.3 to 550.7; 20.4 to 417.5 and from 94.0 to 439.2 respectively. HDL-cholesterol/cholesterol, triglycerides/cholesterol indicators results ranged from 0.19 to 1.00 and from 0.54 to 1.00 respectively. Cholesterol, HDL-cholesterol and triglycerides were higher requested in rural areas. No significant differences in tests requests were observed based on Spanish Community.
There was a high variability in cholesterol, triglycerides and HDL-cholesterol requesting in primary care in Spain. Cholesterol was probably inappropriately under requested to screen for hypercholesterolemia in certain areas that would suggests a potential risk for inappropriate dyslipidemia screening in general population, emphasizing the need to establish interventions.