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Abstract 60: Impact of a Multisite, Protocol-Driven, Nurse Practitioner-Led, Cardiovascular Prevention Program in a Hispanic Medicare Advantage Population at High Risk for ASCVD: Healthy Heart Program at Cano Health

Authors :
Veronica MCCLOSKEY
Khurram Nasir
Rohan Khera
Evangelos K Oikonomou
Robert Diaz
Robert Kenney
Richard Aguilar
Martha Gulati
Oscar H Cingolani
Ty J Gluckman
Ron Blankstein
Marlow B Hernandez
Juan Rivera
Source :
Circulation. 147
Publication Year :
2023
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2023.

Abstract

Introduction: Despite availability of effective and inexpensive pharmacologic therapies for hypercholesterolemia and hypertension, many patients at high risk for atherosclerotic cardiovascular disease (ASCVD) do not achieve optimal low-density lipoprotein (LDL) and systolic blood pressure (SBP) levels. We hypothesized that risk factor control could be improved by using nurse practitioners and a guideline-directed protocol in a Medicare Advantage (MA) population. Methods: We designed and implemented an ongoing 18 site, multistate (FL, TX, NV), ASCVD risk assessment and management program (Healthy Heart) in a large national MA primary care clinic (Cano Health). The cardiometabolic risk assessment and management program was designed by a team of preventive cardiologists, with the plan of being Nurse Practitioner (NP)-led, with remote support by a cardiologist. Protocols provided details on initiation and titration of drug therapy to achieve LDL-C and SBP goals. Patients with organ transplants, advanced cancer, an ejection fraction Results: From October 2021-October 2022, 5430 patients were enrolled in the program. A total of 1858 (34.2%) had established ASCVD, 1033 (19.0%) had diabetes mellitus (DM). A total of 713 (13.1%) had both ASCVD and DM. In patients who had ASCVD and diabetes together, high intensity statin use increased from 39.4% to 68.3% after enrollment; 52.66% achieved an LDL-C Conclusions: Implementing a novel cardiovascular prevention program in a population of mostly Hispanic MA patients at high risk for ASCVD, using NPs, with strict adherence to a step-by-step evidence-based protocol supervised by cardiologists, is associated with reduction in LDL levels and SBP and with improvement in reaching LDL and SBP targets.

Details

ISSN :
15244539 and 00097322
Volume :
147
Database :
OpenAIRE
Journal :
Circulation
Accession number :
edsair.doi...........5e37f7d2fcc103bb251a4a87391d933e
Full Text :
https://doi.org/10.1161/circ.147.suppl_1.60