Using Implementation Science to Improve Guidelines-Based Care to Lower Atherosclerosis Risk Due to Familial...

Implementation science, a multi-method research area that integrates input from constituents and content experts, has emerged as an important tool in improving implementation of evidence-based practices. This review summarizes three ongoing implementation studies focused on identification of patients with significantly increased risk for atherosclerotic cardiovascular disease (ASCVD) due to genomic risk such as familial hypercholesterolemia (FH) within a single health system.

Despite the existence of evidence-based guidelines for identifying individuals with increased risk for ASCVD from FH and managing their care to reduce risk, substantial care gaps exist in guideline implementation. These include patient understanding of the importance of heart disease prevention, clinician implementation of screening for risk factors, and adherence to recommended treatments. While guidelines often focus on the encounter between a patient and clinician, implementation science enlarges the field of study to encompass factors external to the encounter. These factors include multi-level barriers and facilitators to implementation. By developing strategies to overcome barriers and leverage facilitators, management can be improved for those with FH. Implementation science methods described herein are transferable to other health care settings, with a goal of improving preventive medicine practice and increasing adherence to evidence-based practices for FH.