OR24-05 12 Month Lipid Outcomes of High-Risk US Veterans in the VALOR-QI (Veterans Affairs Lipid Optimization Reimagined Quality Improvement) Project

Abstract Disclosure: K.K. Soe: None. R.E. Ward: None. J.M. Gaziano: None. 50 VA sites are participating in a national quality improvement initiative called the VALOR-QI: VA Lipid Optimization Reimagined Quality Improvement Project. VALOR-QI is a collaborative project between the U.S. Department of Veterans Affairs (VA) and the American Heart Association (AHA) with the goal of positively impacting Veterans’ cardiovascular (CV) health. As part of the program, VA sites work with an AHA QI Consultant to develop and deploy a local quality improvement plan to help overcome site specific barriers preventing Veterans from achieving optimal cholesterol levels. The VALOR-QI team consists of healthcare providers (HCP) (primary care, specialist and/or pharmacists) and a health coach. Veterans with an ASCVD diagnosis, baseline (BL) LDL >70 mg/dL, and a qualifying appointment with a VALOR-QI HCP were identified. Various strategies were developed at each VA site with the objectives of 1) engaging the high-risk veterans whose LDL-c goal (<70 mg/dL) was unmet, 2) improving HCP knowledge of ASCVD treatment emphasizing aggressively lowering LDL-c, and 3) improving the awareness and education about ASCVD and cholesterol among veterans. Interim analysis was conducted for 17,450 veterans who had been in the program for at least 12 months (mo) and had at least 2 lipid labs. Demographic distribution of the cohort was as follows: age (mean: 69.7 year, SD: 9.85, range: 22-103), gender (93% male, 7% female), and race (69.2% Caucasian, 21.7% African American, 2.6% other, 6.5% unknown). Adherence was assessed by Medication Possession Ratio (MPR) and MPR > 0.80 was considered adherent. At 12 mo, 31% of the entire cohort reached LDL-c target (<70 mg/dL) and 26% achieved the absolute LDL-c reduction ≥30 mg/dL. The age group (18-54-year-old) showed the highest adherence improvement compared to other age groups (55-64, 65-74, and 75+). African American showed the lowest BL adherence (45.5%), but the highest adherence improvement (20.1% increase) compared to other racial groups. All subgroups (by age, gender, and race) showed increase in LLT usage. The cohort with BL LDL-c ≥100 mg/dL achieved higher reduction of mean LDL-c compared to those with BL LDL >70 mg/dL (27.5 vs 14.4 mg/dL, p-value <0.0001). Both males(M) and females(F) had the similar BL adherence and the improvement at 12 mo (BL M:53.2%, BL F:52.9%, 12mo M:71.9%, 12 mo F:71.2%). But more males achieved LDL-c target than females (M:30.5%, F:19.7%). Thus, after one year of participating in VALOR-QI, a significant reduction in LDL-c was noted across all subgroups of US veterans. This was likely due to improvement in medication adherence, intensification of LLT and awareness of ASCVD risk among veterans and HCP. Presentation: Sunday, July 13, 2025