Evaluation of a Multidisciplinary Lipid Clinic to Improve the Care of Individuals With Severe Lipid Conditions: a RE-AIM Framework Analysis

• DOI: 10.21203/rs.3.rs-51142/v1
• Publication Date: 2020-08-02T17:24:42Z
• Authors: Laney K Jones; Megan McMinn; David Kann; Michael Lesko; Amy C. Sturm; Nicole Walters; Nan Chen; Kerrianne Fry; Ross C. Brownson; Samuel S. Gidding; Marc S. Williams; Alanna Kulchak Rahm
• Keywords: Dyslipidemia

Abstract Background . Individuals with complex dyslipidemia, or those medication intolerance, are often difficult to manage in primary care. They require the additional attention, expertise, and compliance counseling that occurs multidisciplinary lipid clinics (MDLCs). We conducted a program evaluation of first year newly implemented MDLC utilizing RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework provide empirical data not only on but also components important local sustainability future generalizability. Methods The purpose is increase uptake guideline-based care for conditions. Established 2019, provides via centralized clinic location within healthcare system. Primary providers cardiologists were invited refer individuals Using pre/post study design, we evaluated implementation outcomes from using framework. Results In 420 referrals received, 83 patients seen (reach). subgroups, found improved diagnosis condition, prescribing more aggressive lipid-lowering therapies, high rates prior authorization approvals, significant reductions levels (effectiveness). Of 796 active cardiology 18% (146/796) referred (adoption). At patient-level, 50% (41/82) had at least one follow-up visit MDLC, 12% (10/82) having two visits 2019 (implementation). provider-level, an average 35 patient per month made (SD 12) During monthly meetings operational team, decision transition in-person telehealth appointments was capacity sustain (maintenance). Conclusions risk stratification, guideline-recommended treatments prescribed clinically lowering levels. Attention factors including multiple points contact, duration visits, extraneous comorbidities social support could aid better understanding success outcomes.