Abstract 19073: Is There a Need for Tools to Stratify Risk in Patients With Coronary Heart Disease
Introduction: Despite the popularity of the terms “personalized,” “stratified” or “precision” medicine, it is unclear whether practicing physicians perceive the need for more precise risk stratification for patients with stable coronary heart disease (CHD). On the one hand, these “high risk” patients may be considered as already maximally treated by standard-of-care workflows and guidelines, and on the other there may be a perceived opportunity to improve compliance with known effective treatments and lifestyle changes, or to allocate more intensive (and expensive) interventions cost-effectively. Existing risk assessment tools in CVD secondary prevention are imprecise and may mischaracterize some patients, resulting in care gaps.
Hypothesis: Physicians perceive a need for tools to improve risk stratification of patients who are treated for CVD secondary prevention to supplement clinical assessment and laboratory tests, and they have confidence that they could act upon the results.
Methods: We conducted a 30 minute online survey with 153 physicians (59 cardiologists (CD), 91 primary care physicians (PCP) and 3 endocrinologists) to solicit opinions about need for improved risk stratification of patients managed for CVD secondary prevention.
Results: Physicians ranked the following to be the most important areas for improvement: 1) Need for better predictive tests/risk assessment (32% of CDs, 31% of PCPs); 2) better lipid therapies (27% of CDs, 20% of PCPs); 3) patient compliance/motivation (16% of CDs, 31% of PCPs); 4) tests to guide management (10% of CDs, 8% of PCPs). They considered the following to be the key benefits of a risk assessment test: 1) Guide patient management (32% of CDs, 38% of PCPs); 2) reliable risk prediction (29% of CDs, 37% of PCPs); 3) patient compliance/motivation (20% of CDs, 14% of PCPs).
Conclusions: Physicians identified care gaps in CVD secondary prevention and recognized potential benefits of an accurate tool for risk stratification. PCPs highlighted the need for a better tool for patient motivation. Both specialties ranked the benefit of the risk assessment test to guide patient management as most important.
Author Disclosures: K. Maguire: Other Research Support; Modest; SomaLogic. R. Healy: Other Research Support; Modest; SomaLogic.
- © 2016 by American Heart Association, Inc.