Safety Net Program to Improve Statin Initiation Among Adults With High Low-Density Lipoprotein Cholesterol

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• High-intensity statins effectively reduce LDL cholesterol and cardiovascular disease risk.
• Underutilization of statins is a concern in adults with LDL cholesterol ≥190 mg/dL.
• A safety net program, SureNet, was implemented to facilitate medication and laboratory test orders.

Purpose of the Study:

• To determine if the SureNet program improved statin initiation and laboratory test completion.
• To compare statin initiation and adherence before (pre-SureNet) and after (SureNet period) program implementation.

Main Methods:

• Retrospective cohort study of Kaiser Permanente Southern California members aged 20-60 years with LDL cholesterol ≥190 mg/dL.
• Compared statin orders, fills, laboratory test completions, and LDL cholesterol improvement within specified timeframes before and after SureNet implementation.
• Multivariable analysis adjusted for demographics and clinical characteristics.

Main Results:

• The SureNet period saw higher rates of statin orders (27.5% vs 21.5%) and fills compared to the pre-SureNet period.
• Adults in the SureNet period had a significantly higher likelihood of receiving a statin order, filling their statin, and completing laboratory tests.
• The SureNet program was associated with improved low-density lipoprotein cholesterol levels.

Conclusions:

• The SureNet program successfully improved prescription orders, medication adherence, and laboratory test completion rates.
• The program contributed to better low-density lipoprotein cholesterol management in eligible adults.
• Optimizing physician and patient adherence to guidelines and the program is key for enhanced cholesterol lowering.