1937-LB: Coordinated Approach to Improve Quality of Care and Address Disparities in Patients with Cardiometabolic Disease-Analysis from the Cardiometabolic Center Alliance Registry

• Published in: Diabetes (New York, N.Y.) Vol. 73; p. 1
• Main Authors: Kosiborod, Mikhail N, Magwire, Melissa L, O'Keefe, Evan L, Aistrope, Daniel S, Andaya, Emily, Bashall, Anthony, Butler, Javed, Cummings, Katie, Davis, Lisa, Eckel, Robert H, Fialkow, Jonathan A, Harness, Lacy, Miller, Keith A, Neeland, Ian, Patel, Shachi, Plutzky, Jorge, Saalfeld, Rosalie K, Stafos, Andrea, Rajagopalan, Sanjay
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01-06-2024
• Subjects: Cardiovascular diseases; Cholesterol; Low density lipoprotein; Risk factors; Statistical analysis; Triglycerides
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db24-1937-LB

Background: The Cardiometabolic Center Alliance (CMCA) has demonstrated that its comprehensive, coordinated care model achieved statistically significant increases in the use of guideline-directed medical therapies (GDMT) as well as reductions in cardiovascular risk factors. The durability and scalability of this approach and potential impact on care disparities have not yet been assessed. Methods: Using CMCA multicenter registry data (CMCA sites with ≥ 30 participants, each with ≥ 2 visits) we evaluated changes in GDMT utilization across cardiometabolic disease categories, and in the management of key cardiovascular risk factors. Results: In all, 1528 individuals across 6 sites with T2D and CVD and/or CKD were evaluated (median age 66 years, 43.7 % women, 14.1 % black, 63.4 % noncommercially insured, 6-month median follow-up). Sustained improvements in GDMT, reductions in weight, HbA1c, total/LDL cholesterol, triglycerides, and decreases in insulin requirements were observed (p< 0.001 for all); furthermore, the performance on key quality metrics was consistent across racial subgroups. (Figures A and B). Conclusion: The CMCA led implementation of a coordinated, team-based approach, produces durable improvements in GDMT and overall quality of care in patients with cardiometabolic disease and across racial subgroups.