Increasing Statin-Prescribing and Low-Density Lipoprotein Cholesterol Control in Secondary Atherosclerotic Cardiovascular Disease Prevention: A Collaborative Approach.

Abstract

Despite ample evidence supporting their efficacy in atherosclerotic cardiovascular disease (ASCVD) management, statin-prescribing and low-density lipoprotein cholesterol (LDL-C) measurement are underused, especially for vulnerable populations. This study explores the impact of a Best Practices Learning Collaborative to improve the management of patients with ASCVD for secondary prevention. Conducted with the guidance of a subject-matter expert advisory committee, the ASCVD Collaborative convened a geographically diverse group of health care organizations (HCOs) over a 12-month implementation period to set goals, develop and implement interventions, collect and track quality performance measures, and share best practices. Interventions included provider/staff education, clinical decision support tools, care coordination, patient education and awareness, and the treatment of very high-risk patients. HCOs tracked three measures for patients with established ASCVD: any statin prescribed (stratified by sex and race/ethnicity), high-intensity statin prescribed, and LDL-C control (<70 mg/dL). After a 12-month implementation period, HCOs demonstrated improvement in one or more measures. The Collaborative model was shown to be an effective means for achieving improvement in the management of ASCVD, laying the groundwork for future more rigorous studies to identify the most impactful interventions.