The purpose of this study is to determine whether a proactive, EHR-guided approach helps more individuals reach safe cholesterol levels, improves medication use, and reduces future heart attacks and strokes, compared to usual care.
The main question it aims to answer is:
• Does the EHR-LOCALE pathway increases the proportion of patients who reach the LDL-cholesterol target of \<1.8 mmol/L at 6 months?
Participants in the interventional group receive:
* Pharmacist contact * Repeat lipid requisitions * Review of medications, adherence, and side effects * Treatment escalation according to national dyslipidemia guidelines
Adults over the age of 18
Resident of Alberta
Individuals hospitalized with an acute coronary syndrome and have undergone coronary angiography.
Able to participate in follow-up contact if randomized to the intervention arm
None
Parallel
Pharmacist-led lipid optimization pathway
Other interventionReferral to a centralized, pharmacist-led, telephone clinic for optimization of dyslipidemia management
Proportion of individuals who achieve guideline recommended low-density-lipoprotein (LDL) cholesterol target of <1.8 mmol/L at 6-months
Proportion of individuals with repeat lipid panel testing at 3-months and 6-months
Proportion of individuals who undergo escalation or addition of new of lipid lowering therapies
Absolute difference in lipid values (LDL-C, high-density lipoprotein-cholesterol [HDL-C], non-HDL cholesterol, triglycerides) at six-months
Composite of all-cause mortality, hospitalization for myocardial infarction, hospitalization for stroke and unplanned coronary revascularization at one-year and five-years
Cost-effectiveness of a centralized, EHR-augmented dyslipidemia management pathway following an ACS
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