Using Educational Intervention Tools to Combat Implicit Bias and Health Care Inequities

Disparities in hyperlipidemia (HLD) treatment may be significantly decreased by targeting health care inequities with education focused on implicit bias, according to study results presented at the National Lipid Association (NLA) Scientific Sessions 2023, held in Atlanta, Georgia, between June 1 and June 4, 2023.

Investigators sought to assess if system-wide educational modules offered to providers would eliminate implicit biases and health inequities in lipid lowering therapy in adults at the University of Louisville health clinics.

This retrospective analysis included data for 18,757 patients (40-75 years of age; 71.9% White; 26% Black) seen in the family medicine, internal medicine, or cardiology clinics at the University of Louisville, Louisville, KY, in 2019. From 2019 to 2022, follow-up data was collected for statin prescriptions, obesity, diabetes mellitus (DM), hypertension (HTN), lipid profiles, socioeconomic status, and race. System-wide educational modules were presented to providers over 3 years with intention to reduce racial disparities in HLD screening and treatment.

They found that 73% of all patients received lipid screening in 2019 (75% Black; 73% White; P <.0001). Comorbidities were more prevalent in Black patients vs White patients (elevated LDL-C levels, 31% vs 26%; DM, 38.1% vs 29.5%; HTN, 85.7% vs 79.1%; obesity, 57% vs 51%; all P <.0001).

Patients with certain risk factors were more likely to receive lipid screening compared with patients without certain risk factors (DM, 82.9% vs 74%; HTN, 79% vs 68.1%; obesity, 81.3% vs 79.6%; all P <.0001), and they were more likely to receive statins (DM, 64% vs 0%; HTN, 24.5% vs 3.4%; obesity, 26% vs 12.6%; all P <.0001). Overall, a higher percentage of Black patients vs White patients received statins (23.7% vs 11.1%; P <.0001).

“Patients from different racial and socioeconomic groups had equal access to care after educational intervention in 2018…” the study authors wrote.