Improving quality by TARGETing LDL using a systems-based approach to evaluate our current performance (TARGET-LDL)

This study will identify and describe both patients with LDL levels above the target goal and those who lack routine LDL monitoring in terms of sociodemographic factors (age, sex, race/ethnicity, household income, educational attainment), system-level factors (KPNC Service Area, lack of PCP, patient-provider language discordance, distance to the medical center, high copays, polypharmacy) as well as other patient-level factors (e.g., prior MACE event, degree of engagement with the cardiac rehabilitation program, comorbidity burden, vital signs, statin type and dose, other cardiac medications, statin intolerance). We will perform statistical predictive modeling to understand the multivariable drivers of being above an optimal LDL level (70 mg/dL) and lacking routine LDL monitoring. We also will examine the degree to which being above an optimal LDL level (70 mg/dL) is independently associated with increased risk of recurrence of MACE and all-cause mortality.

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