Barriers and Emerging Strategies to Bridge Gaps in Implementation of Evidence-Based Lipid-Lowering Therapies

Area of Science:

• Cardiology
• Public Health
• Pharmacology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) is a major global health concern.
• Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor for ASCVD.
• Despite proven efficacy of lipid-lowering therapies, real-world application remains suboptimal.

Purpose of the Study:

• To review the challenges and barriers to implementing guideline-recommended lipid-lowering therapies.
• To explore potential strategies for improving the real-world effectiveness of these therapies.

Main Methods:

• Literature review of current challenges and proposed solutions.
• Analysis of barriers at healthcare system, medical therapy, and patient levels.
• Examination of novel therapeutic approaches and implementation strategies.

Main Results:

• Significant gaps exist between guideline recommendations and clinical practice for lipid-lowering therapies.
• Barriers include systemic issues, medication complexities, and patient-level factors.
• Emerging strategies like digital health, polypills, and PCSK9 inhibitors show promise.

Conclusions:

• Addressing multifaceted barriers is crucial for optimizing ASCVD prevention.
• A combination of quality improvement, patient-centered tools, and novel therapies can enhance implementation.
• Improved adherence and access to effective lipid management are essential for reducing ASCVD burden.