Evidence Based Management of High LDL-C for Prevention of Atherosclerotic Cardiovascular Disease in Adult Patients in Resident Run Clinic: A QI Project

Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and in the United States, with significant healthcare and economic burden. Despite clear guideline recommendations, the implementation of ASCVD risk assessment and statin use for primary prevention remains suboptimal. Methods: A quality improvement project was conducted at a resident run clinic with an objective to improve ASCVD risk documentation and guideline-based lipid management. A total of 600 patients aged 40-75 years without a history of cardiovascular disease were randomly selected- 300 in the pre-intervention group and 300 in the post-intervention group. The intervention included didactic sessions and quick reference summary cards at workstations. The primary outcome was documentation of 10-year ASCVD risk. Secondary outcomes included statin prescribing patterns and lipid profile monitoring. Data were analysed using Pearson’s Chi squared test. Results: ASCVD risk documentation significantly improved from 22.9% to 34.2% post-intervention (p=0.002). The percentage of diabetic patients on statin declined significantly from 71.8% to 55.6% (p=0.049). Statin use in patients with ASCVD risk >20% and 7.5-20% showed no statistically significant changes. Lipid profile monitoring rates showed non-significant trends toward improvement or decline depending on LDL control status. Conclusions: Targeted educational interventions improved ASCVD risk documentation in our clinic. However, changes in statin prescribing and lipid monitoring were inconsistent. Future efforts should focus on ensuring that improved risk assessment translates into comprehensive cardiovascular risk management through EMR integration, sustained education and patient-centered approaches.