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Chart 4. Team-Based Collaborative Care
Recommendations
Strength Quality
Health care teams for optimal lipid and ASCVD risk
management may include, where available: the patient;
the patient's primary health care provider; nurses; nurse
practitioners; pharmacists; physician assistants; registered
dietitian nutritionists, including certified diabetes educators
in some practices; exercise specialists; social workers;
community health workers; and licensed professional
counselors, psychologists, and health educators.
A High
Health care team members should coordinate care support
among various team members, use evidence-based guidelines/
recommendations for dyslipidemia management, establish a
structured plan for monitoring patient progress, and provide
patients with a variety of tools and resources to improve their
own care.
A High
Team-based collaborative care may be incorporated into the
Patient Centered Medical Home as a strateg y to address
shortfalls in patient health care quality, access, continuity,
and cost.
E Low
General Management
Chart 3. Patient Adherence
Recommendations
Strength Quality
e provider should assess adherence to both lifestyle and atherogenic
cholesterol-lowering medications at every patient encounter.
E Low
A multidisciplinary health care team (such as the patient's primary
health care provider; nurses; nurse practitioners; pharmacists;
physician assistants; registered dietitian nutritionists, including
certified diabetes educators in some practices; exercise specialists;
social workers; community health workers; and licensed
professional counselors, psychologists, and health educators) is
desirable to identify medication non-adherence and to facilitate
strategies to improve adherence by helping patients overcome real
(or perceived) barriers to adherence.
E Low
e multi-faceted approach should be employed by clinicians to
improve medication adherence, including :
a. simplify the regimen
b. provide clear education using visual aids and simple, low-literacy
educational materials
c. engage patients in decision-making, addressing their specific
needs, values, and concerns
d. address perceived barriers of taking medication
e. identify suboptimal health literacy and use "teach-back"
techniques to increase patient understanding of those behaviors
needed to be successful
f. screen and eliminate drug-drug and drug-disease interactions
leading to low adherence or drug discontinuation
g. praise and reward successful behaviors.
E Low
Management
