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The Veterans Affairs Lipid Optimization Reimagined - Quality Improvement Program Rationale and Methods

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Article Type: Original Article Published: 2025-07-27 Volume/Issue: 6 / 7 Pages: 929-937

The Veterans Affairs Lipid Optimization Reimagined - Quality Improvement Program Rationale and Methods

Abigail A Santos*, Jennifer DelGrande, Abigail Fink, Juhi Seth, Courtney Bonnema, Rachel Ward, Helen M Wellman, Nedim Yel, Mason Coleman Lopez, Dakotah Feil, Sharon Sharnprapai, Kristin Colson, Eddie Pan, Tharen Leesch, David Pena, Michelle Congdon, Michele Bolles, Luc Djousse and John Michael Gaziano
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Internal Medicine Public Health Cardiovascular Diseases
The Veterans Affairs Lipid Optimization Reimagined - Quality Improvement Program Rationale and Methods
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Abstract

<p><b>Background: </b>Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to morbidity and mortality in United States (US) Veterans and to healthcare costs in the United States Veterans Affairs (VA) Healthcare System. Optimizing Low-Density Lipoprotein Cholesterol (LDL-C) can improve Veteran health, reduce incidence of cardiovascular events and death, and lower healthcare costs.<br><br><b>Methods: </b>The VA Lipid Optimization Reimagined - Quality Improvement (VALOR-QI) program is an innovative three-year multi-site quality improvement program leveraging various lipid optimization strategies tailored to unique barriers and needs at 50 VA Medical Centers. Program oversight is provided by the Boston VA Coordinating Center and the American Heart Association (AHA), and local teams include a site lead or Clinical Champion (CC), a Healthcare Coach (HC), and a Health Care Provider Network (HCPN) of clinicians treating Veterans with ASCVD. Outcome data are collected through the VA electronic health record database and QI data are collected through the VA Research Electronic Data Capture (REDCap) system. Primary and secondary outcomes include the percentage of Veterans with optimized LDL-C (&lt;70 mg/dL), absolute and percent change in LDL-C, use of lipid lowering therapies, medication adherence, cardiovascular risk score, and healthcare utilization and costs. Lipid optimization outcomes will be stratified by key Veteran demographics including geographic region, age, sex assigned at birth, race, and ethnicity.<br><br><b>Results: </b>N/A- Program still in progress<br><br><b>Conclusions: </b>We will assess whether a novel quality improvement program can optimize lipids in Veterans with ASCVD at high risk for cardiovascular events, with subsequent improvement of Veterans’ health and reduction of costs for US Veterans and the VA Healthcare System. Findings from this program can inform clinical processes and guidelines for the VA Healthcare System and other healthcare systems alike.<br></p>

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