1937-LB: Coordinated Approach to Improve Quality of Care and Address Disparities in Patients with Cardiometabolic Disease—Analysis from the Cardiometabolic Center Alliance Registry
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 
Published: June 2024

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&lt; 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.

Disclosure

M.N. Kosiborod: Research Support; AstraZeneca. Consultant; AstraZeneca. Other Relationship; AstraZeneca. Research Support; Boehringer-Ingelheim. Consultant; Boehringer-Ingelheim. Research Support; Pfizer Inc. Consultant; Pfizer Inc., 35Pharma, Alnylam, Amgen Inc., Applied Therapeutics, Arrowhead Pharmaceuticals, Inc., Bayer Inc., Cytokinetics Inc., Dexcom, Inc., Eli Lilly and Company, ESPERION Therapeutics, Inc., Imbria Pharmaceuticals, Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, Pharmacosmos A/S, Regeneron Pharmaceuticals Inc., Sanofi, scPharmaceuticals, Structure Therapeutics, Inc., Vifor Pharma. Other Relationship; Vifor Pharma. Consultant; Youngene Therapeutics. Stock/Shareholder; Artera Health, Saghmos Therapeuticals. M.L. Magwire: Consultant; Novo Nordisk, Boehringer-Ingelheim, Merck & Co., Inc. D.S. Aistrope: None. E. Andaya: None. A. Bashall: Stock/Shareholder; Lilly Diabetes, Lexicon Pharmaceuticals, Inc., Novo Nordisk. J. Butler: Consultant; Abbott, American Regent, Amgen, Applied Therapeutic. Other Relationship; AstraZeneca. Consultant; Bayer. Other Relationship; Boehringer Ingelheim. Consultant; Bristol Myers Squibb, Cardiac Dimension, Cardior, CVRx, Cytokinetics, Janssen, Daxor Edwards, Element Science. Other Relationship; Eli Lilly. Consultant; Innolife. Other Relationship; Impulse Dynamics. Consultant; Imbria, Inventiva, Lexicon, LivaNova, Medscape, Medtronics, Merck, Occlutech. Other Relationship; Novartis. Consultant; Novo Nordisk, Pfizer, Pharmacosmos, Pharmain, Roche, Secretome, Sequana, SQ Innovation, Tenex, Tricoq. Other Relationship; Vifor. K. Cummings: None. L. Davis: Speaker's Bureau; Amgen Inc. R.H. Eckel: Other Relationship; Amgen Inc. Consultant; Novo Nordisk. Advisory Panel; Ionis Pharmaceuticals, Arrowhead Pharmaceuticals, Inc. Other Relationship; Regeneron Pharmaceuticals Inc. J.A. Fialkow: Speaker's Bureau; Amarin Corporation, Amgen Inc. Advisory Panel; Novo Nordisk. Speaker's Bureau; ESPERION Therapeutics, Inc. L. Harness: None. K.A. Miller: Speaker's Bureau; Boehringer-Ingelheim. I. Neeland: Speaker's Bureau; Boehringer-Ingelheim. Consultant; Eli Lilly and Company. Advisory Panel; Novo Nordisk A/S. Speaker's Bureau; Bayer Inc. Consultant; Nestlé Health Science. J. Plutzky: Other Relationship; Novo Nordisk. Research Support; Boehringer-Ingelheim. Consultant; Boehringer-Ingelheim, Amgen Inc., Novartis Pharmaceuticals Corporation, Altimmune Inc., Merck & Co., Inc. R.K. Saalfeld: None. A. Stafos: None. S. Rajagopalan: Consultant; Novo Nordisk, Bayer Inc.

Funding

Funding/Sponsors: AstraZeneca, Boehringer Ingelheim, Amgen, Novo Nordisk