Program helping patients lower cholesterol nets international award

A 2019 Kaiser Permanente program has helped patients with high levels of “bad cholesterol” start taking medications to lower their cholesterol and decrease their risk of stroke and heart attacks.

This month, this SureNet Statin Start program was recognized with a prestigious UNIVANTS of Healthcare Excellence Award, and even more importantly, has significantly improved the lives of patients with high cholesterol, enhancing their prospects for a longer and healthier lives.

Evaluation of the program was published in April 2023 in the American Journal of Preventive Medicine. The award recognized those who led the evaluation of the program, including Tracy Imley, MD, Michael Kanter, MD, Matthew Mefford, PhD, Ronald Scott, MD, and Dr. Kristi Reynolds, PhD, MPH.

“We are deeply honored to receive this award because it recognizes the hard work of not only the named winners but all those within Kaiser Permanente Southern California who had a hand in helping these patients lower their cholesterol,” said Dr. Reynolds, a chronic disease epidemiologist and the director of Epidemiologic Research for the Kaiser Permanente Southern California Department of Research & Evaluation.

Bad cholesterol and its outcomes

While your body needs cholesterol to perform many functions, having too much bad cholesterol can cause health problems. One type of cholesterol — LDL cholesterol, or low-density lipoprotein cholesterol — is especially problematic.

LDL cholesterol is often called bad cholesterol because it can build up in the walls of your blood vessels, raising your risk of heart attack and stroke.

The program helps patients with high LDL cholesterol start taking statins, which are prescription drugs that lower cholesterol and reduce the risk of heart attacks and strokes.

Getting patients the treatment they need

The effort was part of a larger Kaiser Permanente SureNet program to identify and close gaps in patient care. Clinical leaders saw that some patients with very high cholesterol were not taking statins because they did not fill or refill their prescriptions. The clinicians developed the SureNet Statin Start program to address the issue.

“The risk for heart disease goes way down when we put patients with high cholesterol on statins,” said Dr. Michael Kanter, of the Kaiser Permanente Bernard J. Tyson School of Medicine and the Kaiser Permanente Southern California Department of Research & Evaluation. “We realized that some patients were not starting on statins when they should. The program notified the patients’ primary care doctors, and the number of patients picking up their statins improved by 32%.”

The program was a joint effort of our clinicians, pharmacy and laboratory leadership, and scientists in the Department of Research & Evaluation. After the program was in place, patients were:

  • 32% more likely to fill their statin prescriptions
  • 41% more likely to complete a follow-up lab test
  • 21% more likely to lower their LDL cholesterol

How the program works

To identify patients in need of statins, the program scans our members’ electronic health records.

It looks for patients not taking statins who have LDL cholesterol levels of 190 milligrams per deciliter or above. This level of LDL cholesterol is very high. Very high cholesterol puts people at high risk for heart attacks and strokes.

The program then alerts each identified patient’s personal doctor. It recommends that the doctor approve a statin prescription and follow-up blood test for the patient.

Once the doctor approves, the patient receives a notification to pick up medication and have a checkup for cholesterol levels.

“Heart disease is one of the top causes of death in the United States,” said Dr. Matthew Mefford,  a research scientist at the Department of Research & Evaluation. “Our research shows that this program is helping members lower their cholesterol. That should translate into fewer heart attacks and strokes in the future.”

Supporting healthier, longer lives

Patients are often surprised and a little concerned when they learn that they have high cholesterol, according to Dr. Ronald Scott, a family medicine physician and cardiovascular co-lead for the Southern California Permanente Medical Group.

“However, they’re grateful to learn more about the seriousness of their condition and how to treat it,” Dr. Scott said. “Statins lower cholesterol dramatically and are very safe.”

“The program is a shining example of how we use our integrated care model to make sure patients get high-quality care,” said Nancy Gin, MD, regional medical director of Quality and Clinical Analysis for the Southern California Permanente Medical Group.

“It took the efforts of many people in multiple areas of our organization to make this program work, and our patients are living healthier lives,” Dr. Gin said. “It’s one more proud moment for all of us at Kaiser Permanente.”

To learn more

Image from left to right: Dr. Reynolds, Dr. Mefford, Dr. Kanter, Dr. Imley, Dr. Scott