Abstract 13178: Attainment of LDL-C Goals is Associated With Measures of Patient Engagement With Their Healthcare Providers

Abstract

Introduction: Achieving optimal levels of low density lipoprotein cholesterol (LDL-C) reduces risk of cardiovascular events. We have found substantial gaps in LDL-C goal attainment in employees and spouses with an employer-sponsored medical plan. Understanding how patients’ engagement with healthcare providers affects LDL-C goal attainment may inform gap-closure programs. Methods: The study was drawn from 35,276 participants in an annual health assessment program offered by nation-wide clinical diagnostic provider to employees and spouses between September 2017 and June 2018. We excluded those with <1 consecutive year of employer- sponsored health plan and those younger than 40 or older than 75. The analysis was further limited to 7,363 participants who would benefit from LDL-C management according to the AHA/ACC definition of patient-management groups. The association between attaining LDL-C goal and education, socioeconomic status, and self-reported measures of engagement with healthcare providers was assessed in age, sex, and ethnicity adjusted logistic regression models. Results: Attaining LDL-C goal was more likely in those with a personal physician than in those without (OR =2.25, 95%CI, 1.70 to 2.99, P <0.0001). Similarly, greater confidence in selecting a physician, talking with a physician, or understanding medical benefits, as well as a more recent physical exam and a greater number of medications were associated with greater odds of attaining LDL-C goal ( Figure, all P values <0.0001). Socioeconomic status and education levels were not associated with attaining LDL-C goals ( P >0.05). Conclusion: Confidence in interaction with healthcare providers (understanding benefits, selecting a physician, and talking with a physician) was associated with LDL-C goal attainment in those with an employer-sponsored health plan. Improving patients’ confidence in their ability to interact with healthcare providers may improve LDL-C goal attainment.