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Improving Statin Prescribing for People Living With HIV: A Quality Improvement Initiative
Veronica Njuguna1, John Hawkins1, Navya Pothamsetty2
1Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.
Insights
Improving statin prescribing for people living with HIV (PLWH) is crucial due to their increased cardiovascular risk. A quality improvement initiative significantly boosted statin prescriptions through education and feedback.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- People living with HIV (PLWH) face elevated risks of atherosclerotic cardiovascular disease.
- Current guidelines advocate for statin therapy in eligible PLWH (aged 40-75 with ≥5% 10-year ASCVD risk).
- Statin prescribing remains suboptimal in this patient group.
Background:
People living with HIV (PLWH) have increased atherosclerotic cardiovascular disease risk. Guidelines recommend statin therapy for PLWH aged 40 to 75 years with a 10-year atherosclerotic cardiovascular disease risk of ≥5%.
Project Rationale:
Statin prescribing is suboptimal in this population. We implemented a quality improvement initiative to identify barriers and increase statin prescribing in eligible PLWH.
Project Summary:
Seventeen of 25 (68%) Kaiser Permanente HIV specialists were surveyed on barriers to statin prescribing and participated in a quality improvement initiative that provided monthly education and prescribing feedback. Statin prescriptions among PLWH aged 40 to 75 years were assessed before the intervention (June-December 2024) and during the intervention (January-June 2025) using interrupted time series. Seventeen of 25 specialists (68%) participated. Reported barriers included patient reluctance (71%), nonautomated risk calculation (58%), and limited resources (47%). Baseline statin prescribing was 44.1%. Monthly prescribing increased from 0.30% preintervention to 1.24% postintervention (P < 0.001), yielding 193 additional prescriptions.
Take-Home Message:
An intervention combining ongoing education with monthly performance feedback significantly improved statin prescribing rates among PLWH.
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