Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome
Objective: Controlling of low-density lipoprotein cholesterol (LDL-C) in patients with acute coronary syndrome (ACS) remains a challenge. Health information technology (HIT) is increasingly being applied to close quality gaps in chronic illness care. The aim of this study was to perform a qualitativ...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266666772300154X |
| _version_ | 1797237921447673856 |
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| author | Yi-Sheng Chen Heng Hsu Lin Hao-Yuan Tsai Chien-Lin Lee Yen-Ting Yeh Yen-Wen Wu |
| author_facet | Yi-Sheng Chen Heng Hsu Lin Hao-Yuan Tsai Chien-Lin Lee Yen-Ting Yeh Yen-Wen Wu |
| author_sort | Yi-Sheng Chen |
| collection | DOAJ |
| description | Objective: Controlling of low-density lipoprotein cholesterol (LDL-C) in patients with acute coronary syndrome (ACS) remains a challenge. Health information technology (HIT) is increasingly being applied to close quality gaps in chronic illness care. The aim of this study was to perform a qualitative review of the association of implementing HIT on lipid management processes of care and LDL-C goal attainment in patients with ACS. Method: Eligible patients with a discharge diagnosis of ACS from January 2018 to December 2021 at a tertiary medical center were retrospectively reviewed. An HIT system with a multidisciplinary approach including initiating high-intensity statin therapy, periodic laboratory follow-up, titration of lipid-lowering agents, patient education, patient-level and system-level interventions involving database monitoring and outreach by centralized care teams was introduced in October 2018. Electronical medical records including data on medications and laboratory findings at discharge and within 1 year were compared before and after implementing the HIT system. Results: A total of 2001 ACS patients (average age 63 ± 12.7 years, 79.66 % men) were analyzed. The LDL-C < 70 mg/dL goal attainment rates (36.52 %, 53.57 %, 59.22 %, 62.18 % in 2018–2021) and medium serum LDL-C levels (80.5 mg/dL, 68 mg/dL, 65 mg/dL, 64 mg/dL in 2018–2021) significantly improved within 6 months (2018 as the reference, all p<0.001). The LDL-C attainment rate at 12 months also steadily increased (53.80 %, 61.82 %, 64.21 % in 2019–2021, p = 0.019). Most of the patients switched to a high-intensity statins regimen at discharge (0.57 %, 63.67 %, 72.41 %, 84.44 %, in 2018–2021, p<0.001 with 2018 as the reference), with low adverse event rates. The maintenance rates of high-intensity statin regimens at 12 months continued to improve (41.36 %, 49.04 %, 61.39 % in 2019–2021, p<0.001). Conclusions: Efforts to control LDL-C should be increased in ACS patients by initiating and intensifying statin treatment earlier. Our results confirmed that a team-based strategy with HIT improved LDL-C target achievement for most patients with ACS. |
| first_indexed | 2024-03-09T14:15:09Z |
| format | Article |
| id | doaj.art-d715a60561f442298846a0e486d8fa95 |
| institution | Directory Open Access Journal |
| issn | 2666-6677 |
| language | English |
| last_indexed | 2024-04-24T17:27:26Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj.art-d715a60561f442298846a0e486d8fa952024-03-28T06:39:05ZengElsevierAmerican Journal of Preventive Cardiology2666-66772024-03-0117100613Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndromeYi-Sheng Chen0Heng Hsu Lin1Hao-Yuan Tsai2Chien-Lin Lee3Yen-Ting Yeh4Yen-Wen Wu5Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, New Taipei City, Taiwan; Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan; Corresponding author at: No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City 220, Taiwan.Objective: Controlling of low-density lipoprotein cholesterol (LDL-C) in patients with acute coronary syndrome (ACS) remains a challenge. Health information technology (HIT) is increasingly being applied to close quality gaps in chronic illness care. The aim of this study was to perform a qualitative review of the association of implementing HIT on lipid management processes of care and LDL-C goal attainment in patients with ACS. Method: Eligible patients with a discharge diagnosis of ACS from January 2018 to December 2021 at a tertiary medical center were retrospectively reviewed. An HIT system with a multidisciplinary approach including initiating high-intensity statin therapy, periodic laboratory follow-up, titration of lipid-lowering agents, patient education, patient-level and system-level interventions involving database monitoring and outreach by centralized care teams was introduced in October 2018. Electronical medical records including data on medications and laboratory findings at discharge and within 1 year were compared before and after implementing the HIT system. Results: A total of 2001 ACS patients (average age 63 ± 12.7 years, 79.66 % men) were analyzed. The LDL-C < 70 mg/dL goal attainment rates (36.52 %, 53.57 %, 59.22 %, 62.18 % in 2018–2021) and medium serum LDL-C levels (80.5 mg/dL, 68 mg/dL, 65 mg/dL, 64 mg/dL in 2018–2021) significantly improved within 6 months (2018 as the reference, all p<0.001). The LDL-C attainment rate at 12 months also steadily increased (53.80 %, 61.82 %, 64.21 % in 2019–2021, p = 0.019). Most of the patients switched to a high-intensity statins regimen at discharge (0.57 %, 63.67 %, 72.41 %, 84.44 %, in 2018–2021, p<0.001 with 2018 as the reference), with low adverse event rates. The maintenance rates of high-intensity statin regimens at 12 months continued to improve (41.36 %, 49.04 %, 61.39 % in 2019–2021, p<0.001). Conclusions: Efforts to control LDL-C should be increased in ACS patients by initiating and intensifying statin treatment earlier. Our results confirmed that a team-based strategy with HIT improved LDL-C target achievement for most patients with ACS.http://www.sciencedirect.com/science/article/pii/S266666772300154XAcute coronary syndromeHealth information technologyHigh intensity statinLowdensity lipoprotein cholesterol |
| spellingShingle | Yi-Sheng Chen Heng Hsu Lin Hao-Yuan Tsai Chien-Lin Lee Yen-Ting Yeh Yen-Wen Wu Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome American Journal of Preventive Cardiology Acute coronary syndrome Health information technology High intensity statin Lowdensity lipoprotein cholesterol |
| title | Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| title_full | Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| title_fullStr | Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| title_full_unstemmed | Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| title_short | Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| title_sort | association of health information technology driven multidisciplinary approaches with low density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome |
| topic | Acute coronary syndrome Health information technology High intensity statin Lowdensity lipoprotein cholesterol |
| url | http://www.sciencedirect.com/science/article/pii/S266666772300154X |
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