| Sumario: | Supplemental Digital Content is Available in the Text. Introduction: Less than 1/5th of eligible patients are prescribed statins for primary prevention in the United States. Methods: We conducted a quality improvement program augmented by contextually responsive implementation strategies (IS), Plan-Do-Study-Act cycles, and Lean Six Sigma Principles to optimize statin therapy among 40–75-year-old patients without atherosclerotic cardiovascular diseases (ASCVD) in primary prevention in resident internal medicine clinic. We conducted needs assessment; identified process measures, barriers to statin optimization using discussions; and rank ordered these barriers. We mapped multiple IS to the barriers using discussions/consensus over 2 years. We retrofitted the IS to the Expert Recommendations for Implementing Change (ERIC) taxonomy to facilitate IS reporting. Results: We noted significant improvement in process measures such as lipid panel orders (64.6% vs. 95.5%), its completion (78.6% vs. 95.3%), ASCVD risk score completion (3% vs. 91%), and statin therapy optimization (34.5% vs. 90%) over 2 years among eligible patients (baseline vs. final cohort, respectively; all p ≤.001). Conclusions: Using improvement and implementation science to identify needs assessment, process measures, and barriers in statin optimization and mapping IS to the barriers can help improve statin optimization in primary prevention. Our reporting of IS using the ERIC taxonomy should further help operationalize IS in other contexts.
|