Optimizing treatment of dyslipidemia in patients with coronary artery disease in the managed-care environment (the Rocky Mountain Kaiser Permanente Experience)

Rocky Mountain Kaiser Permanente has taken aggressive steps to ensure optimal treatment of all modifiable cardiac risk factors, especially low-density lipoprotein (LDL) cholesterol, in patients with coronary artery disease. In this article, we are presenting (1) the basic rationale for our approach,...

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Bibliographic Details
Published in:The American journal of cardiology 2000-02, Vol.85 (3), p.36-42
Main Authors: Merenich, John A, Lousberg, Tammy R, Brennan, Stacy H, Calonge, Ned B
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiovascular disease
Cholesterol, LDL - blood
Colorado
Coronary Disease - blood
Coronary Disease - complications
Coronary Disease - therapy
Coronary vessels
General and cellular metabolism. Vitamins
Health care
Health Maintenance Organizations - organization & administration
Humans
Hyperlipidemias - blood
Hyperlipidemias - complications
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Lipids
Managed Care Programs - organization & administration
Medical sciences
Patient Satisfaction
Pharmacology. Drug treatments
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Summary:Rocky Mountain Kaiser Permanente has taken aggressive steps to ensure optimal treatment of all modifiable cardiac risk factors, especially low-density lipoprotein (LDL) cholesterol, in patients with coronary artery disease. In this article, we are presenting (1) the basic rationale for our approach, (2) the critical steps translating philosophy into practice, and (3) justification for all health plans to pursue a similar course. The continuum of physician-directed disease management systems that have evolved in our region—one administered by cardiology nurses in the perihospitalization period and the other by pharmacists in the long-term, outpatient setting—is then detailed. Although the relatively short duration that our comprehensive systems have been in place precludes any assessment of their impact on cardiac death, coronary artery disease events, or coronary artery disease procedure rates, the improvements in intermediate surrogate outcomes are promising. Virtually all surveyed patients participating in our management systems have been “very” or “extremely” satisfied with their experience. The LDL-cholesterol screening rate in the approximately 2,500 participants in the programs to date has reached 97%. Of these patients, 84% have LDL cholesterol
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(99)00937-6