INTRODUCTION: Since 2003, Kaiser Permanente (KP) has implemented innovative cardiovascular disease (CVD) risk-reduction clinical practices in Northern and Southern California that emphasize the use of cardioprotective medications-aspirin, angiotensin-converting enzyme inhibitors, and statins-in individuals at very high risk of experiencing heart attacks and strokes. Because an internal KP retrospective analysis demonstrated decreased morbidity and mortality among KP patients with diabetes, there is significant value in implementing this strategy in the broader community population, particularly in safety-net clinics serving the uninsured. METHODS: To implement this risk-reduction clinical practice in the community, clinical and programmatic sections of KP had to connect with a set of community partners that share a similar approach of evidence-based prevention. Successful implementation required a well-planned and coordinated collaboration between KP and the community entities that allowed for and supported adaptation in local delivery structures. RESULTS: Forty-six ambulatory clinic sites based at community health centers and in public hospital/health systems in California's safety net have initiated KP's CVD risk-reduction program. This resulted in 1125 community-clinic patients in Southern California and 1120 patients in Northern California receiving their first prescription for at least 1 of the 3 cardiovascular medications within the first 18 months of implementation. KP Colorado, KP Georgia, and KP Northwest are also implementing these strategies in their local communities. DISCUSSION: The results of program initiation demonstrate successful translation of the KP CVD risk-reduction strategy to the broader, non-KP member community: uptake of 46 community clinic sites in 2 KP Regions, with a projection of >11,000 patients being prescribed the 3 cardioprotective medications in subsequent years and in multiple Regions. This may be a model for further spread of CVD prevention measures, and prevention programs for other diseases, to all populations throughout the US, notably underserved communities disproportionately affected by chronic conditions.
INTRODUCTION: Since 2003, Kaiser Permanente (KP) has implemented innovative cardiovascular disease (CVD) risk-reduction clinical practices in Northern and Southern California that emphasize the use of cardioprotective medications-aspirin, angiotensin-converting enzyme inhibitors, and statins-in individuals at very high risk of experiencing heart attacks and strokes. Because an internal KP retrospective analysis demonstrated decreased morbidity and mortality among KP patients with diabetes, there is significant value in implementing this strategy in the broader community population, particularly in safety-net clinics serving the uninsured. METHODS: To implement this risk-reduction clinical practice in the community, clinical and programmatic sections of KP had to connect with a set of community partners that share a similar approach of evidence-based prevention. Successful implementation required a well-planned and coordinated collaboration between KP and the community entities that allowed for and supported adaptation in local delivery structures. RESULTS: Forty-six ambulatory clinic sites based at community health centers and in public hospital/health systems in California's safety net have initiated KP's CVD risk-reduction program. This resulted in 1125 community-clinic patients in Southern California and 1120 patients in Northern California receiving their first prescription for at least 1 of the 3 cardiovascular medications within the first 18 months of implementation. KP Colorado, KP Georgia, and KP Northwest are also implementing these strategies in their local communities. DISCUSSION: The results of program initiation demonstrate successful translation of the KP CVD risk-reduction strategy to the broader, non-KP member community: uptake of 46 community clinic sites in 2 KP Regions, with a projection of >11,000 patients being prescribed the 3 cardioprotective medications in subsequent years and in multiple Regions. This may be a model for further spread of CVD prevention measures, and prevention programs for other diseases, to all populations throughout the US, notably underserved communities disproportionately affected by chronic conditions.
Authors: Robert W Yeh; Stephen Sidney; Malini Chandra; Michael Sorel; Joseph V Selby; Alan S Go Journal: N Engl J Med Date: 2010-06-10 Impact factor: 91.245
Authors: Rachel Gold; John Muench; Christian Hill; Ann Turner; Meena Mital; Christina Milano; Amit Shah; Christine Nelson; Jennifer E DeVoe; Gregory A Nichols Journal: J Health Care Poor Underserved Date: 2012-08
Authors: Rachel Gold; Celine Hollombe; Arwen Bunce; Christine Nelson; James V Davis; Stuart Cowburn; Nancy Perrin; Jennifer DeVoe; Ned Mossman; Bruce Boles; Michael Horberg; James W Dearing; Victoria Jaworski; Deborah Cohen; David Smith Journal: Implement Sci Date: 2015-10-16 Impact factor: 7.327
Authors: Rachel Gold; Christine Nelson; Stuart Cowburn; Arwen Bunce; Celine Hollombe; James Davis; John Muench; Christian Hill; Meena Mital; Jon Puro; Nancy Perrin; Greg Nichols; Ann Turner; MaryBeth Mercer; Victoria Jaworski; Colleen Howard; Emma Abiles; Amit Shah; James Dudl; Wiley Chan; Jennifer DeVoe Journal: Implement Sci Date: 2015-06-10 Impact factor: 7.327
Authors: Rachel Gold; Arwen E Bunce; Deborah J Cohen; Celine Hollombe; Christine A Nelson; Enola K Proctor; Jill A Pope; Jennifer E DeVoe Journal: Mayo Clin Proc Date: 2016-04-23 Impact factor: 7.616
Authors: Rachel Gold; Annie E Larson; JoAnn M Sperl-Hillen; David Boston; Christina R Sheppler; John Heintzman; Carmit McMullen; Mary Middendorf; Deepika Appana; Vijayakumar Thirumalai; Ann Romer; Julianne Bava; James V Davis; Nadia Yosuf; Jenny Hauschildt; Kristin Scott; Susan Moore; Patrick J O'Connor Journal: JAMA Netw Open Date: 2022-02-01