Increasing statin utilization in patients at high risk of atherosclerotic cardiovascular disease in remote physiological monitoring program

Abstract

Statement of the problem: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide costing the United States an estimated $200 billion a year. Dyslipidemia, a leading risk factor for ASCVD, is well controlled by statin medications. Despite high efficacy, low cost, and a favorable safety profile, statins are underutilized. A healthcare facility in Montana aimed to increase utilization of statins in high-risk populations through pharmacist chart reviews. Methods: The quality improvement case manager at the healthcare facility conducted a review of patient charts to identify those at high risk for ASCVD who were not receiving statin therapy based on MIPS #438 recommendations. The case manager identified patients that would benefit from a statin and referred them to a pharmacist for a medication chart review. The pharmacist then called the patient to complete a medication chart review and sent recommendations for medication changes to the patient's primary care provider (PCP). Results: Twenty-two patients were initially identified for statin therapy with 13 deemed eligible. Six of them (46%) agreed to a pharmacist chart review and were contacted by the pharmacist, all of whom agreed to statin therapy. The pharmacist made an average of two additional medication changes recommendations per review. Thus far, three patients followed up with their provider and started statin and one patient completed a repeat lipid panel. Conclusion: Pharmacist outreach can increase statin utilization in patients at high-risk of ASCVD. Further research should focus on improving statin tolerability and ability to contact patients.