Abstract 14664: Integrated Atherosclerotic Cardiovascular Disease Lipid Management Initiative

Abstract

Introduction: In the US, 48.6% of adults ≥40 years of age are eligible for statin therapy. Since the release of updated ACC/AHA guidelines in 2018, statin use and mean low-density lipoprotein cholesterol (LDL-C) levels remained unchanged, suggesting that enhanced efforts to understand and implement guideline-directed therapies are needed. Objective: The ASCVD Lipid Management Initiative’s primary goals are to increase the proportion of very-high risk ASCVD patients achieving LDL-C levels < 70 mg/dl and to increase appropriate referrals to lipid management clinics. Methods: The AHA has engaged a cohort of six diverse health systems (caring for 40,000 patients) to characterize current clinical lipid management care pathways, identify barriers to treatment and to partner to refine lipid management strategies. The methods of the 3-year intervention focus on implementation science, peer-to-peer learning, and patient engagement. Results: In the first 12 months of the intervention, health systems collectively identified several common barriers and developed corrective actions to promote standardization of lipid management ( Table ). Organizations are participating in regular quality improvement discussions with an AHA consultant and attending quarterly ASCVD Learning Collaborative calls to share insights and strategies. This initiative has implemented a Referral to Lipid Management measure in the Get With The Guidelines(R) - Stroke and Coronary Artery Disease registries and piloted an outpatient registry with a focus on ASCVD and risk factor related measures. A unique identifier system is being developed to follow patients from inpatient to outpatient settings, as well as an app to facilitate patient activation. Conclusion: Together, AHA and health systems are identifying barriers to lipid management and implementing strategies to optimize ASCVD care pathways. We will evaluate the impact of the intervention on LDL-C and referrals for lipid management.