AMGA and Pfizer Inc. present the Models of Excellence Collaborative on Patient Adherence and Health Literacy

Midwest Heart Specialists, Lombard, IL
A Process for Addressing the Practical Barriers to Statin Non-Adherence in the Outpatient Setting

“In a clinical setting, statin medications led to less LDL lowering than reported in clinical trials summarized in package inserts.” ¹

This deficiency illuminates the challenge of motivating coronary artery disease (CAD) patients to adhere to their statin regimen¹. It ultimately translates into poor lipid control and poor outcomes and suggests that many patients in the outpatient environment on statin therapy may receive no or limited benefit from statins.

The Practice plans to combat the problem of statin non-adherence in part by utilizing resources gained by the funding of this proposal to develop a new patient care process that automates cholesterol profile follow-up. The Practice hopes that by offering patients a convenient way to self-administer their cholesterol profile at home more patients will adhere to their statin prescription. The test results, processed by an external service, would quickly stream back to the Practice. The added convenience of the service would translate into more patients having a cholesterol profile on chart who are more aware of the importance of monitoring their cholesterol profile.

The discrete elements that we plan to address in the pilot include providing:

• a convenient test method for patients and clinicians to access
• enhanced communication and tools for relaying test results and appropriate educational tools to patients
• increased automation in cholesterol profile reporting and a point-of-care alerting mechanism reminding staff to follow-up for cholesterol profile testing and statin prescription dosing and refills

At the outset of the pilot, six physicians from the Practice for the period of one month will offer their patients with CAD who are on statin the ability to use the FDA approved home cholesterol test service described in detail in the Appendix I. The Practice will track outcomes and process improvement variables with on-line chart reviews of impacted patients. The Practice will measure success of the pilot by measuring the increase of lipid profiles on chart, adherence to statin prescription guidelines and improvements in lipid lowering. The results will compare the intervention group with a usual care group not enrolled in this new testing service.

The Practice is very confident that this proposed pilot project will increase statin adherence because it increases the patient’s awareness of the subject. We feel that this pilot is a practicable, manageable intervention, which has the potential to impact 30,000 patients in the Practice.

1. Assemble multidisciplinary Models of Excellence Team represented by the following:
   1. Physician champion
   2. Clinical Informatics Specialist (data analyst)
   3. Registered Nurse
   4. Representative of Administration
2. Initiate the involvement of the Strategic Planning Committee
   1. Propose plan of action to Committee (Physician)
   2. Obtain comments
   3. Revise plan based on comments (Nurse, analyst)
3. Educate all clinical staff about goals and initiatives and materials (Physician, Nurse)
4. Develop educational materials (Nurse)
5. Develop survey for qualitative look at how staff views process (Nurse, Adm. Rep)
6. Monitor data collection and collect feedback from clinical staff about the new process (Nurse, Analyst)
7. Final data analysis (MOE Team)
   1. Mine for data elements in clinical database (Analyst)
   2. Generate and publish results

Website Terms and Conditions of Use and Privacy Policy