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Innovative, centralised, multidisciplinary medicines optimisation clinic for PCSK9 inhibitors.

Rani Khatib1,2,3, Mutiba Khan3, Abigail Barrowcliff3

  • 1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK r.khatib@leeds.ac.uk.

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A new service improved access to Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is), significantly lowering cholesterol in patients. The model supports both eligible and ineligible patients for better lipid management.

Keywords:
AtherosclerosisDelivery of Health CareHyperlipidemias

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Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are underutilized for optimizing lipid management.
  • A new service was developed to enhance patient access to PCSK9is, aligning with National Institute for Health and Care Excellence guidelines.
  • This paper details the service model, presenting lipid-lowering outcomes and patient feedback from the initial 100 referrals.

Purpose of the Study:

  • To describe a novel, centralized multidisciplinary service designed to improve patient access to PCSK9 inhibitor therapy.
  • To evaluate the effectiveness of the service in optimizing lipid levels and patient adherence.
  • To assess patient satisfaction and the broader applicability of the service model.

Main Methods:

  • A centralized, multidisciplinary clinic was established as the sole prescriber of PCSK9 inhibitor therapy in the region.
  • Referred patients underwent eligibility assessments and received personalized support, education, and monitoring.
  • The service also provided support for patients not meeting PCSK9 inhibitor eligibility criteria.

Main Results:

  • Of 100 referred patients, 48 were initiated on PCSK9 inhibitor therapy.
  • Significant reductions in lipid levels were observed: mean total cholesterol decreased by 41%, and mean low-density lipoprotein-cholesterol (LDL-C) by 58% at 3 months (p<0.0001).
  • These lipid reductions were sustained at 12 months, with high patient satisfaction reported.

Conclusions:

  • The innovative, person-centered, multidisciplinary service successfully initiated PCSK9 inhibitor therapy and improved long-term monitoring and adherence.
  • The service effectively provided medication optimization and adherence support to both eligible and ineligible patients.
  • This model demonstrates potential for wider implementation to improve PCSK9 inhibitor uptake and therapeutic outcomes in other healthcare settings.