With Huge Opportunities for Cardiovascular Secondary Prevention, Better Adoption Strategies will be Critical

January 8, 2020 – In response to a recent study that found the majority of cardiovascular patients are eligible for at least one of 12 novel secondary prevention therapies, representatives from the DCRI urge a focus on implementation of these therapies into clinical practice.

The wide range of new therapies for cardiovascular secondary prevention raises questions about the best way to use these therapies in clinical practice and underscores the need for novel approaches to implement these therapies into routine patient care, according to a recent editorial in JAMA Cardiology written by DCRI fellow Michael Nanna, MD, (pictured left), and DCRI’s Eric Peterson, MD, MPH (pictured right).

Michael Nanna, MDThe editorial, titled “Translating the Secondary Prevention Therapeutic Boom Into Action,” accompanied a study by Martin Bodtker Mortensen, MD, PhD, and colleagues, which examined a population of more than 8,000 patients to determine the proportion of patients who were eligible for 12 novel cardiovascular preventive therapies. Findings from the study were compelling, with 80 percent of patients with a prior myocardial infarction eligible to receive four or more new therapies.

These new therapeutic choices are daunting particularly because there is no evidence defining what the optimal combination of these therapies are. Implementation of these therapies into clinical practice is also a significant concern. “Despite the billions of dollars spent yearly by pharmaceutical companies on prescriber detailing and direct-to-consumer marketing, the scientific breakthroughs of the last decade remain unrealized for most eligible patients,” Nanna and Peterson write.Eric Peterson, MD, MPH

More work needs to be done to drive faster drug adoption.  “To date, multifaceted strategies that combine clinician education, real-time feedback, performance incentives, policy changes, and patient engagement strategies have proven most effective,” Nanna and Peterson write. They also note that future opportunities in this arena exist in using the electronic health record to identify patients who are eligible for treatments and alert clinicians of opportunities to improve care.