Dyslipidemia: Current Therapies and Strategies to Overcome Barriers for Use

Abstract

Dyslipidemia continues to be a major predictor of adverse cardiovascular outcomes in patients with risk factors as well as diagnosed atherosclerotic cardiovascular disease. Recent clinical trials and national guidelines from the US Preventive Services Task Force, American College of Cardiology, and American Heart Association have reinforced a paradigm shift from quantitative reduction of low-density lipoprotein cholesterol targets to prevention and risk factor reduction. Optimized medical therapies have become more inclusive of patients in both the primary and secondary care settings. Although statins continue to be a cornerstone of all recommended therapeutic options, many barriers to patient adherence with medical therapy exist. As medical options change to include the newer lipid-lowering treatments, patient adherence and provider practice challenges can diminish the benefits these medications offer. Although the phenomenon of adherence is complex, multidisciplinary teams, technology, improved communication, prior authorization, step-wise approaches, and the streamlining of the appeal process have shown benefit to mitigate cardiovascular disease-related sequelae. A current overview of practitioner barriers such as organizational restrictions, as well as patient challenges such as poor health literacy and poverty, are examined. Collaborative, multidisciplinary planning and interventions are reviewed with suggestions to increase patient adherence and optimize treatment regimens. This article reinforces existing knowledge while providing new insights to these issues.