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Managing Dyslipidemia for PCPs

CE / CME

Optimizing Cardiovascular Health: Attaining LDL-C Targets Through Comprehensive Therapeutic Approaches—A Primary Care Update

Nurse Practitioners/Nurses: 1.00 Nursing contact hour

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit™

Released: August 21, 2024

Expiration: August 20, 2027

Rachel M. Bond
Rachel M. Bond, MD, FACC
CME/CE Information

Activity

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Course Completed

Setting the Stage for Shared Decision-making: 2018 Blood Cholesterol Guideline Checklist

Partnering with patients to improve cardiovascular outcomes is important. 

There are several different options for both primary and secondary prevention and determining what makes the most sense for each individual patient is key. The best way to do this is to implement shared decision-making. Yes, guidelines are important, but they do not provide individual patient–level recommendations. Clinicians must focus on each patient’s ASCVD risk, lifestyle modifications, and how each can manage cost considerations. Considering all these points, a discussion on the benefits vs risks of these medications will help patients make the best decision for themselves.20

Engaging Patients in Shared Decision-making: 2018 Blood Cholesterol Guideline Checklist

There are several key steps to engaging patients in shared decision-making. The teach-back method can be utilized to get insights and find out what the patient has learned. Inviting the patient to ask questions and inquiring about their preferences is also helpful. Finally, discussing barriers to adherence will allow providers to collaborate with patients to develop their unique treatment and follow-up plan. These choices can be overwhelming for patients and shared decision-making and collaborative discussions create opportunities for patients to understand and better determine why one pharmacotherapy makes the most sense for them vs another.20

Navigating Financial Access Barriers

 

Navigating financial access barriers is key for many patients. Although most commercial or private insurance companies have many lipid-lowering agents on formulary, some will require prior authorizations, peer-to-peers, or appeals. It is important to have detailed notes justifying use of the restricted agent, such as including that the patient has utilized the maximum dose of a statin and they are compliant with lifestyle changes. Insurance companies will often not approve adding on an additional medication if they see patients are not exercising and eating appropriately. Many insurance companies do accept copay cards for assistance, which can be helpful.49 For the uninsured, there are free clinics and often ways to work with them to obtain treatments.50 When it comes to Medicare, it is often necessary to review formulary, and assist in applying for extra coverage when needed. It is also important to keep the open enrollment period in mind as well.51

Impact of Social Determinants of Health

Clinicians also must be mindful of the impact of social determinants of health because we know that when it comes to outcomes, 80% are based on socioeconomic factors, a patient’s physical environment, and their health behaviors. When thinking about how to best treat patients, it is important that social determinants of health are considered as well.52 

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