Care Coordination & Electronic Medical Records Aggressively Lower Patient's Cholesterol, Kaiser Permanente Study Finds

More than 40 percent of very high-risk patients able to reach national cholesterol guidelines

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May 13, 2010, 02:59 ET

OAKLAND, Calif., May 13 /PRNewswire/ -- When the National Cholesterol Education Program issued revised cholesterol goals in 2004 recommending people at very high-risk for heart disease move their target LDL or "bad" cholesterol from 100 mg/dL to 70 mg/dL to reduce the risk for another heart attack, many health experts questioned if the lower goal was possible. Now, new research from Kaiser Permanente Colorado demonstrates that more than 40 percent of patients were able to reach the aggressive cholesterol targets.

The study, which is the largest to date demonstrating how many patients can get to the lower goal, is published in the May issue of the Journal of Clinical Lipidology.

Of the 7,247 Kaiser Permanente patients studied, 43.4 percent lowered their bad cholesterol to less than 70 mg/dL. This is significant because according to the researchers, previous studies have shown it's difficult to move a patient's LDL cholesterol to such low levels. Previous research found only between 15 and 30 percent of patients were able to get their cholesterol to the newly recommended goal.

The majority of patients who attained an LDL less than 70 mg/dL in the study were receiving a statin or a combination of statin and other cholesterol-lowering therapies.

"Kaiser Permanente's integrated care delivery model, supported by electronic medical records and health information technology, has great benefits for patients with heart disease over the long-term," said study author Kari Olson, PharmD, of Kaiser Permanente Colorado. "We believe our patients achieved their cholesterol goals at higher rates because of our proactive team approach, close monitoring and follow-up, and the computer systems we have in place."

Every Kaiser Permanente Colorado patient with a history of heart disease is offered enrollment into a disease management program called the Collaborative Cardiac Care Service. Clinical pharmacy specialists, along with nurses, work to increase the number of patients on long-term lipid-lowering therapy, manage medications known to decrease the risk of future heart attacks, and provide patient education recommendations for a healthy lifestyle. Electronic medical records and computerized disease registries help care teams coordinate care for this population.

Previous research from the Kaiser Permanente Colorado CCCS found patients enrolled in the program had a 76 percent reduction in overall mortality, 73 percent reduction in cardiac mortality, and an estimated avoidance of 135 deaths and 260 emergency interventions annually.

The majority of patients included in this study--nearly 89 percent--attained the old target of less than 100 mg/dL. This rate is much higher than national data, which shows that less than 50 percent of patients with heart disease get their LDL to less than 100 mg/dL.

The study also found older patients and men were significantly more likely to attain the LDL cholesterol goal of less than 70 mg/dL. Women were 25 percent more likely to fail to attain goal, as were individuals younger than 65 years and patients not receiving statin therapy. Researchers are not certain why women are affected differently.

"Managing cholesterol in patients is difficult, and we know it's much more than writing a prescription and hoping individuals take the medication," said co-author Amy Kauffman, PharmD of Kaiser Permanente Colorado. "Our study suggests that a combination of care coordination, technology, and close monitoring and follow up may ultimately get more people to the aggressive cholesterol targets over the long term."

Additional study authors include: Morgan L. Youngblood, PharmD, Emily B. Zadvorny, PharmD, Thomas Delate, PhD, MS, and John A. Merenich, MD, all associated with Kaiser Permanente Colorado's Clinical Pharmacy Cardiac Risk Service Study Group.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

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SOURCE Kaiser Permanente