Improving Lipid Management and Patient Adherence: Insights from the AHA 2024 Scientific Sessions

In an Interview with Pharmacy Times® at the American Heart Association (AHA) 2024 Scientific Sessions, Rachel Chandra, PharmD, MPH, FASHP, clinical pharmacy practitioner at the Dayton Veterans Affairs Medical Center discussed currently guidelines for low density lipoprotein cholesterol (LDL-C) therapies for patients with atherosclerotic cardiovascular disease (ASCVD), as well as how to navigate obstacles posed by patient hesitancy and treatment adherence.

Pharmacy Times: Can you give some insight into what your session at the AHA 2024 Scientific Sessions was about?

Wooden blocks spelling HDL, LDL | Image Credit: © surasak - stock.adobe.com

Rachel Chandra, PharmD, MPH, FASHP: So today we there are a group of 5 of us, 4 physicians and myself as a pharmacist, speaking about in a round table about medication adherence and provide a hesitancy as it pertains to lipid management in patients with ASCVD.

Pharmacy Times: What are the existing guidelines for lipid management? What is the significance of LDL-C for secondary prevention of ASCVD?

Chandra: As it pertains to the guidelines in lowering LDL for high-risk patients, the goal is to have LDL less than 70 and for very high-risk patients less than 55 lowering LDL overall in patients for those respective targeted populations puts them at a lower risk for having heart disease and additional cardiovascular events.

Pharmacy Times: What challenges do you commonly see in regard to lipid medication adherence and patient hesitancy? Are there any misconceptions or myths around these treatments and ASCVD prevention strategies?

Chandra: Quite a bit too, that's involved in that question. So, with regards to patient care and patient hesitancy, sometimes it's about, in my clinical experience, it's a lot about patient education and provider education as well. We think of LDL as cholesterol so and when statins or other medication, lipid lowering medications are on board and LDLs are at a certain number are at goal, sometimes patients tend to have the impression that,
oh, my cholesterol set goal so I can pause on my medication.” So, some of the approaches that I've done in in our clinic is to provide education such that cholesterol medications are heart medications, and it provide it provides a higher prioritization with regards the importance of adherence, as opposed to cholesterol medication, so they tend to adhere to their statins more often.

Pharmacy Times: What methods for improving treatment adherence were raised in the discussion?

Chandra: That's a great question. Fortunately, at the round table discussion, there were several providers at different clinical settings, and myself as a pharmacist in an outpatient clinical setting. So some of the more common ones that we've all experienced is getting to that point of providing patient autonomy—having the patient be in charge of their own care, as well as providing patient centric care, such that we ensure that we address those social determinants of health and health disparities across populations, recognize that the majority of healthcare happens at home, not in the 20 minute doctor's office that most patients experience. So, meeting patients where they are, ensuring that they're the education that's provided is at a literacy rate that's appropriate for them, and meeting their needs where they are, so that they feel empowered to take charge of their own care.

Pharmacy Times: What is the benefit of meetings like the AHA Scientific Sessions, and how do they help advance optimal patient care initiatives?

Chandra: This is my first time attending the AHA Scientific Sessions, and I am completely impressed. I have historically attended public health conferences and pharmacy conferences. I think I would definitely be back for another one because of the connections with AHA staff and learning about the different programs that are available, as well as the literature that that comes. You get super informed about new approaches and technologies that are available to improve patient care.