Implementing Statin Therapy in Primary Care for Management of Cardiovascular Risk

Abstract

Problem : At a family care practice, a chart audit revealed that 72% of eligible patients ages 40- 75 who met the Atherosclerotic Cardiovascular Disease (ASCVD ) risk criteria were on statin therapy, which is below the practice goal of 80-100%. Purpose: The purpose of this quality improvement initiative is to implement an embedded ASCVD risk calculator in the electronic health record (HER) which will alert providers to calculate the risk of stroke, cardiovascular, and heart disease in order to initiate statin therapy for patients with a 10% and greater cardiovascular risk. Methods: The ASCVD risk calculator format and equation was emailed to the IT department, who will embed the ASCVD risk calculator in the EHR. The equation was reviewed by IT department including plan, format and implementation process. It was determined that the equation should be placed next to the vital signs tool to provide easy access for providers to calculate the ASCVD score, and the score will be very noticeable in bold print and a different color. During implementation, weekly audits was conducted to assess whether eligible patients were screened using the enrollment form, ASCVD risk calculator and if those who were screened and meet criteria were initiated on statin therapy. Results: Twenty four out of twenty- four (100%) patients were screened using the ASCVD risk calculator. Seven (7) out of twenty-four (24) were prescribed statin therapy already or were initiated with statin therapy. Seventeen (17) of the patients screened did not meet the criteria per the ASCVD risk calculator to be initiated on statin therapy or were excluded from the screening because they are on other therapy. Conclusions: Statin therapy is recommended for adults 40 years and older with 10% or more significant cardiovascular risks and one or more risk factors like hypertension and diabetes.