Opinion
Video
Optimizing Treatment of Patients on LDL-C–Lowering Therapies
Author(s):
Panelists discuss how health care teams can ensure patients remain on optimal low-density lipoprotein cholesterol (LDL-C)–lowering therapy by leveraging collaborative strategies, facilitating therapy intensification, and incorporating essential components into shared decision-making tools to personalize treatment plans.
Optimizing LDL-C Management in Clinical Practice
Strategies for Ensuring Optimal LDL-C–Lowering Therapy
Systematic monitoring: Implement regular lipid panel follow-ups and automated reminders in electronic medical record systems to identify patients not meeting LDL-C target levels
Risk stratification: Prioritize therapy intensification based on atherosclerotic cardiovascular disease (ASCVD) risk factors and comorbidities to focus on high-risk patients requiring more aggressive intervention
Algorithm-based approaches: Develop clear clinical pathways and decision trees for therapy escalation that can be implemented by the entire health care team
Team-based care models: Utilize pharmacists, nurse practitioners, and care coordinators for medication reconciliation, adherence monitoring, and protocol-driven therapy adjustments
Facilitating Therapy Intensification Through Collaboration
- Delegation protocols: Establish collaborative practice agreements allowing qualified team members to adjust medications per defined protocols without requiring physician visits
- Cross-disciplinary education: Ensure all team members understand current lipid guidelines and therapy options to provide consistent messaging
- Patient engagement systems: Implement proactive outreach to patients with suboptimal LDL-C level control to discuss therapy intensification
- Care transitions management: Develop structured handoffs between inpatient and outpatient settings to maintain continuity of lipid management
Essential Components for Shared Decision-Making Tools
- Personalized risk visualization: Interactive tools showing individual ASCVD risk reduction with various therapy intensification options
- Adverse effect profiles: Clear comparisons of potential adverse effects between treatment options with absolute risk data
- Cost considerations: Transparent information about medication costs, insurance coverage, and available assistance programs
- Treatment burden assessment: Tools to evaluate the impact of additional medications on quality of life and daily routines
- Value clarification exercises: Methods to help patients prioritize their health goals and concerns about additional therapies
Cultural adaptations: Decision aids that address cultural beliefs and preferences about medication use and cardiovascular risk management
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