Testing
Cost, distress and clinician reluctance are the main barriers to Lp(a) testing, qualitative study of 50 participants (J Clin Lipidol 2026)
Original title: Examining barriers and facilitators to testing lipoprotein(a): Understanding at-risk individual and clinician perspectives
Qualitative focus-group study with 26 clinicians and 24 at-risk individuals, using the Integrated Screening Action Model (I-SAM) to categorise barriers and facilitators to Lp(a) testing as motivational, capability and opportunity factors. Facilitators included perceived clinical utility, emotional reassurance from understanding prior cardiovascular events, using Lp(a) knowledge to prepare for the future, and active patient requests for testing. Barriers included a perceived lack of clinical utility, potential emotional distress from results, uncertainty and knowledge gaps around Lp(a), cost concerns, low expectations for testing, and clinician reluctance. The authors conclude Lp(a) testing decisions are multifactorial, offering several intervention points, and that clearly conveying how Lp(a) informs risk assessment and treatment may be key to encouraging wider testing.
Original abstract
Background: Lipoprotein(a) (Lp[a]), is a significant risk factor for cardiovascular disease, yet is infrequently measured.
Objective: A qualitative investigation was designed to better understand the barriers and facilitators to Lp(a) testing.
Methods: Focus groups were held with clinicians (n = 26) and at-risk individuals (n = 24). Transcripts were thematically analyzed, guided by the Integrated Screening Action Model (I-SAM). Consistent with the I-SAM, barriers and facilitators of Lp(a) measurement were categorized as motivational, capability, and opportunity factors.
Results: Facilitators identified included perceived clinical utility, emotional reassurance associated with a newfound understanding of prior events, the ability to use Lp(a) knowledge to better prepare for the future, as well as active requests for testing. Barriers identified included a lack of perceived clinical utility and the potential to cause emotional distress with results, uncertainty and knowledge limitations around Lp(a), cost-related concerns, low expectations for testing, and clinician reluctance to test.
Conclusions: This analysis highlights that Lp(a) testing decisions are multifactorial, providing multiple opportunities for intervention and improvement. Strategies to convey how Lp(a) measurement can inform risk assessment and treatment approaches may be foundational to encouraging more widespread testing.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.