NURSING ROLE AND SUPPORT IN ASSIMILATING PCSK9 INHIBITORS INTO LIPID THERAPY

Abstract

PCSK9 inhibitors enable high risk patients with atherosclerotic cardiovascular disease and/or heterozygous familial hypercholesterolemia to achieve Canadian guideline recommended lipid treatment targets. Only a minority of patients are able to benefit from this therapy. Some reasons include lack of affordability and patient reluctance to embrace a new treatment. Purpose of the project: The purpose of this project is to: 1) describe current trends in PCSK9 inhibitor use for patients attending a lipid clinic in Western Canada and 2) identify factors that cardiovascular (CV) nurses should consider in helping patients access and accept this medication into their treatment regimen. This analysis includes data from a sample of 79 individuals prescribed PCSK9 inhibitors from May 2016 to April 2018. Twenty seven percent (21/79) declined the prescription, received private coverage or were declined insurance and compassionate coverage by both suppliers. Seventy three percent (58/79) received the medication provided by suppliers while insurance options were investigated. Of those, 52% (30/58) went on to receive third party insurance, 48 % (28/58) continued to receive the medication by compassionate coverage. Although not formally evaluated, nursing interventions that assist in reducing patient apprehension included regular contact, education, assistance with documentation and reinforcement. Implications for Practice: CV nurses are in a position to advocate for and assist in navigating challenges associated with acquiring and using a specialized drug such as PCSK9 Inhibitors. CV nurses require knowledge and practical information to support this unique group of individuals incorporate PCSK9 inhibitors into their lipid therapy.