The objective of this clinic-wide initiative performed at the Fanno Creek Clinic (Portland, Oregon) was to investigate whether LDL cholesterol targets (<100 mg/dL) could be achieved with a personalized LDL-lowering intervention in a community-based, internal medicine outpatient setting. For that purpose, 1,375 patients were screened for blood lipid levels at baseline and across the intervention period. Those with elevated LDL cholesterol concentrations (n=514) were given action plans to lower their blood cholesterol levels and 443 of them returned 3-4 months later for a second measurement of blood lipids. Of those patients, 167 met the National Cholesterol Education Program-Adult Treatment Panel III goal of <100 mg/dl, 87 patients returned with plasma LDL cholesterol levels between 100 and 130 mg/dl, and 158 patients returned with LDL cholesterol levels ≥130 mg/dl and therefore did not meet their LDL cholesterol targets. Those patients received a further “action plan” and were asked to come back 3-4 months later for another blood lipid profiling. Of the 50 patients who came back for a third visit, 16 had LDL cholesterol levels <100 mg/dl and 26 had LDL cholesterol levels between 100 and 130 mg/dl. Altogether, these results suggest that primary care providers could do a better job at maintaining or lowering their patients’ LDL cholesterol concentrations to targeted levels. In that regard, patients with high LDL cholesterol levels could benefit from a more personalized, sustained intervention.
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