INTRODUCTION

Patient Provider

Unique Users 4,109 5,832

Returning Users 883 1,106

Survey Respondents 126–482 261–1,137

Handout Downloads 436 -

Patients (N = 482)

% Female 67%

Mean Age (Years) 58

Commercial Insurance Medicare or MedicaidDo Not Know

56%41%3%

Hypercholesterolemia Disease Duration (Years) 14

Providers (N = 1,137)

Physician 24%

Nurse Practitioner or Physician Assis-tant 41%

Nurse/Nurse Navigator 43%

Pharmacist 14%

Medical Assistant 2%

Table 1. Web App User Metrics

Figure 1. Patient Self-Reported Perceptions

Patient and Provider Estimates of Patient’s Preference for Being “Highly Involved” in SDM

Experience > 2-week delays from prescription to insurance coverage

approval of PCSK9i therapy

Have experienced insurance denial of cholesterol medication(s)

prescribed by provider

Experience high/very high satisfaction with current

cholesterol therapy

Receive high/very high support from clinicians in navigating

insurance coverage

Have high/very high understanding of their insurance coverage

Figure 3. Patients’ Top Treatment Goals vs Providers’ Perceptions of Patients’ Goals

Table 2. Demographics

Lipid.Care Web Apps: Digital Technology to Facilitate Collaborative Learning and Patient-Centered Practice Among Cardiology and Lipid Care Teams and Patients With Hypercholesterolemia

Chris K Guerin, MD, FACE1; Erin O’Connell Peiffer, BA2; Paula J Eichenbrenner, MBA, CAE3; Cherilyn L Heggen, PhD4; Jeff Carter, PhD4; Tamar Sapir, PhD4; Kathleen Moreo, RN-BC, BSN, BHSA, CCM, CDMS

(1) ) Advanced Metabolic Care and Research, San Diego, CA (2) Eldersburg, MD (3) AMCP Foundation, Alexandria, VA (4) PRIME Education, LLC, Fort Lauderdale, FL

#268

Recent advances in the treatment of hypercholesterolemia offer marked improvements in cardiovascular risk reduction and the long-term outlook for many patients1,2. However, gaps at the patient, provider, and payer level often limit the extent to which patients benefit from these developments. These barriers include, but are not limited to:

• Suboptimal patient and provider knowledge about evidence-based treatment for hypercholesterolemia and cardiovascular risk reduction3

• Challenges in navigating managed care processes for therapy access4,5

• Lack of engagement in shared decision-making (SDM)3

Effective tools are needed to support patients and providers in SDM and navigating access to appropriate therapies3. With lipid.care, we developed and evaluated educational patient and provider web apps that present users with aligned content designed to close gaps in SDM and timely treatment.

Key findings from the patient and provider surveys:

• Patients reported experiencing barriers to accessing needed therapies for hypercholesterolemia, including denials of prescribed therapy and delays in therapy approval

• Patients and providers had limited confidence in and understanding of managed care processes

• Providers vastly underestimated the proportion of patients who would like to be highly involved in treatment decisions for hypercholesterolemia

• Following engagement with the web app, providers demonstrated increased confidence in navigating managed care requirements, and committed to improving care by adapting documentation workflows to better support patients through the PA process

• 80% of providers committed to sharing the web apps with their patients

The lipid.care web apps present a model for patient and provider education aligned with the principles of SDM, and may be useful to encourage adoption of treatment guidelines in PAs, electronic PAs, and EHR management.

There are no relationships to disclose for Chris K Guerin, MD, FACE; Erin O’Connell Peiffer, BA; Paula Eichenbrenner, MBA, CAE; Cherilyn L Heggen, PhD; Jeff Carter, PhD; Tamar Sapir, PhD; and Kathleen Moreo, RN-BC, BSN, BHSA, CCM, CDMS.

This project was funded by an educational grant from Sanofi US and Regeneron Pharmaceuticals. The study sponsors did not play a role in the design or analysis of the study or in the decision to submit for presentation.

Contact: t.sapir@primeinc.org

• We developed patient and provider web apps that present aligned content on evidence-based treatment recommendations for hypercholesterolemia and cardiovascular risk reduction, combined with tools and strategies for applying SDM and navigating managed care processes.

• The web apps were reviewed by leading cardiology and endocrinology experts, a patient advocate, and representatives from the Academy of Managed Care Pharmacy (AMCP) Foundation and the Case Management Society of America (CMSA) to ensure relevance across stakeholders.

• Pre- and post-education survey items were embedded to evaluate the effectiveness of the tools and to assess patient and provider perceptions of hypercholesterolemia treatment and management.

• Users navigating through the web app can bookmark relevant information, tips, and resources to a personalized handout for download.

• The browser-based experience (vs native smartphone app) ensures easy access on any internet-enabled device without the need to download any software or register an account.

1. Sabatine MS, et al. N Engl J Med. 2017;376:1713–1722.

2. Schwartz GG, et al. N Engl J Med. 2018;379:2097–2107.

3. AHA. Cholesterol Summit Report 2017. Available at https://wwwheart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_494491.pdf. Accessed 2/4/2020.

4. Doshi JA, et al. Circ Cardiovasc Qual Outcomes. 2018;11(1):e003939.

5. Navar AM, et al. JAMA Cardiol. 2017;2(11)1217.

Figure 2. Provider Self-Reported Measures Figure 4. Provider Post-Program Commitment to Improve Care

Ratings of 4 or 5 on a 5-point Likert scaleN = 1,137

Pre-Activity Post-Activity

Patients (N = 482)

Patients (N = 482)

Providers (N = 1,137)

Providers (N = 1,137)

N = 482

N = 1,137

14%20%

36%

25%

10%

31%38%

13%

2%

11%

METHODS

RESULTS

AUTHOR DISCLOSURES

REFERENCES

CONCLUSIONS

Lower LDL-C

Prevent CV Events

Extend Lifespan

Quality of Life

MaintainIndependence

Improve documentation of patient information

Keep copies of patients’ insurance requirements

Submit prior authorizations (PAs) electronically

Enroll or train staff to oversee PA process

Share web app with their patients

36%

54%

42%

34%

31%

28%

80%

51%

84%

29%

54%

23%

31%90%

lipid.care