Strategies for enhancing the initiation of cholesterol lowering medication among patients at high cardiovascular disease risk: a qualitative descriptive exploration of patient and general practitioners’ perspectives on a facilitated relay intervention in Alberta, Canada

Abstract

ObjectiveThe objective of our study was to explore the perspectives of patients and general practitioners (GPs) regarding interventions to increase initiation of cholesterol lowering medication (or statins), including a proposed laboratory-based facilitated relay intervention.DesignQualitative descriptive study using interviews and focus groups for data collection, and thematic analysis for data analysis.SettingPrimary care providers and patients in Calgary, Alberta, Canada.Participants17 GPs with primarily community-based, non-academic practices with at least 1 year of practice experience participated in semistructured interviews. 14 patients at high risk of cardiovascular disease participated in focus groups.Main outcome measuresExploration of strategies that might be used to enhance the prescription of, and adherence to statin therapy for patients with statin-indicated conditions.ResultsGPs proposed a variety of interventions to improve statin prescription, including electronic record audit solutions, GP directed education, and patient-oriented campaigns. Patients expressed that they may benefit from being provided access to their laboratory test results, as well as targeted education. Both parties provided positive feedback on the proposed laboratory-based facilitated relay intervention, while pointing out areas for improvement. Notably, GPs were concerned that the patient-directed component of the intervention might jeopardise therapeutic relationships, and patients were concerned about accidental disclosure of personal health information. Important considerations for the design of facilitated relay messaging should include brevity, simplicity and the provision of contact information for inquiries.ConclusionsGPs and patients described several suggestions for increasing statin initiation and welcomed the proposal of a laboratory-based facilitated relay strategy. These findings support further testing of this intervention which may enhance GPs’ ability to successfully engage patients in cardiovascular risk reduction through statin therapy.

Estimating Prevalence and Characteristics of Statin Intolerance among High and Very High Cardiovascular Risk Patients in Germany (2017 to 2020)

“…From the physician’s viewpoint, there are several barriers associated with the prescription of and adherence to statin therapies, including partial knowledge, inconsistent clinical guidelines, and a lack of a system to identify the right patients for statin therapy. However, from the patient’s viewpoint, fear of side effects and resistance to taking additional medications are key barriers [ 33 , 34 ]. Hence, there is an opportunity to educate physicians and patients during the treatment journey.…”

Long-Term Association Between Intensive Medical Treatment and The Incidence of Cardiovascular Outcomes in Patients with Dyslipidemia: an Observational Study

“…The bene t of statin therapy is also related to the overall risk and intensity of treatment. Patients with diabetes have a higher CV risk than those without diabetes; high-intensity statin therapy is preferred for patients with diabetes [12,14,15]. However, no randomized clinical trial of treatment with high-intensity statins has been conducted in cohorts exclusively comprising patients with T2DM.…”

Long-Term Association between Intensive Medical Treatment and the Incidence of Cardiovascular Outcomes in Patients with Dyslipidemia: an Observational Study

“…The benefit of statin therapy is also related to the overall risk and intensity of treatment [ 15 ]. Patients with T2DM have a higher CV risk than those without T2DM; high-intensity statin therapy is preferred for patients with T2DM [ 14 , 16 , 17 ]. However, no randomized clinical trial of treatment with high-intensity statins has been conducted in cohorts exclusively comprising patients with T2DM.…”