8/24 Cholesterol Test and Patient Interview

Cholestech LDX Analyzer

Point of care (POC) testing

Does not have to be performed by laboratory; can be performed at a pharmacy or clinic

CLIA waived

• Tests cleared by FDA for home use or those with low risk of incorrect use

• Need to have a CLIA Certificate

Measures TC, HDL-, and triglycerides in a single cassette

• Can also measure glucose, AST, or ALT depending on cassette

General 3-step process for Cholestech LDX Analyzer

1. Perform fingerstick and collect sample with capillary tube within 10 sec

2. Dispense sample into test cassette

3. Insert cassette into machine and press RUN button

Results ready in ~5 min

Then, interpret results and convey information to patient

Preparation for test

Cassettes for testing are normally stored in the refrigerator

If a box is being used, then it may be stored at room temperature

Make sure cassette has been at room temperature for 10 minutes before use

Get other supplies ready:

• Gauze, alcohol swab, bandage, lancets, nitrile gloves

• Capillary tubes and capillary plungers

• Biohazard waste container

Collecting blood sample

1. Wear gloves

2. Swab finger with alcohol

   • Best to use finger with least amount of callouses

3. Poke side of finger with lancet at 90 deg angle

4. Squeeze drop of blood

5. Wipe away first drop of blood with gauze

6. Then fill capillary tube to the black line (~40 microliters)

7. Wipe away any excess blood and apply bandage

Placing sample into test cassette

Make sure that cassette is right side up (you will be able to read Cholestech)

1. Transfer blood from vial into well on cassette

2. Place cassette in LDX Analyzer

3. Do not touch magnetic strip

Conducting a patient interview

Asking key questions to help:

• Assess patient’s ASCVD risk

• Assess if patient should see their primary care provider regarding cholesterol

• Guide your recommendations for patient

Questions to ask patient

• Medical history

• Current medications, supplements, vitamins/minerals, herbals

• Current lifestyle habits (diet, exercise, smoking, etc.)

Medical history of ASCVD

• Have you ever experienced [heart attack, stroke, chest pain, open heart surgery, etc.]?

• has your doctor ever told you that you have []?

Other important comorbidities

• Diabetes

• Kidney disease

• Family history of very high cholesterol

• Family history of early death related to heart disease

Explaining results to a patient

1. Read their level and then say what the goal or desirable level should be.

2. State if their level is high, low, or at a desirable level

   • If levels are at goal/desirable level, then let them know they are doing well

   • If levels are not at goal/desirable level, then advise them to follow up with their health care provider

3. Can provide encouragement for lifestyle modifications if you have time.

4. Check for patient understanding.

High cholesterol is usually not a medical emergency (suggest them to schedule appointment with physician), but high triglycerides is (suggest getting help right away).