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Managing physician lipid management: a population wide, risk-based decision support approach
1VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, CA USA ; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA USA ; VA QUERI Center for Implementation Practice and Research Support, VA Greater Los Angeles Healthcare System, Sepulveda, CA USA ; Department of Medicine, VA Greater Los Angeles Healthcare System and UCLA Geffen School of Medicine, Los Angeles, CA USA ; RAND Health, RAND Corporation, Santa Monica, CA USA.
Abstract:
Successful implementation of clinical guidelines for preventing complications of dyslipidemias has been an ongoing challenge. The article by Vinker and colleagues in this journal investigates the results of implementing risk-based guidelines for LDL (Low Density Lipoprotein) management in comparison to the prior approach of using the same LDL cutoff for patients at all levels of risk. Results show LDL levels dropped across the primary care population using the new risk-based approach, suggesting that clinical decision aids that link to individual patient characteristics, rather than promoting a universal target for all, may provide a particularly strong stimulus for changing provider and patient behavior. Results also challenge healthcare organizations, providers and patients to learn more about the pathway from guidelines to clinical reminders and from reminders to lower LDL levels and better population health.
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