Table 1.

Mapping of identified barriers to corresponding implementation strategies and activities for Lp(a) testing.

Barriers addressed	Area of action	Implementation activity
• Lack of knowledge about Lp(a) as a cardiovascular risk factor • Lack of knowledge about Lp(a) impact on patient management • Difficulty in interpreting data • Lack of dedicated therapies • Lack of laboratory equipment (i.e., test kit) • Deprioritization of the test to optimize budget expenditure	Training	1. Development of interactive recorded training for both clinicians and laboratory professionals
• Lack of knowledge about Lp(a) as a cardiovascular risk factor • Lack of knowledge about Lp(a) impact on patient management • Lack of knowledge about guidelines and upcoming drugs • Difficulty in interpreting data • Lack of dissemination of guidelines and positive KOLs' opinions • Lack of awareness about patient management	Tools sharing	1. Promotion of a web algorithm-based cardiovascular risk calculator 2. Design of posters showing cardiovascular risk charts and patient management flowcharts
• Lack of confidence in having a positive impact • Lack of awareness about patient management • Lack of self-monitoring tools • Lack of motivational drivers	Working group	1. Creation of a working group coordinated by a KOL and open to all HCPs in the pilot centers
• Low test reliability and lack of standardization • Delayed test results due to outsourcing and lack of indications	Alignment with laboratories	1. Test management, prescription and report optimization through clinician-lab collaboration
• Lack of confidence to engage in an empathetic conversation with patients about Lp(a)	Patient support	1. Development and promotion of educational material to be handed out during visits

HCPs, healthcare professionals; KOL, key opinion leader; Lp(a), lipoprotein(a).