(P063) SUSTAINED USAGE OF AN APP FOR RISK STRATIFICATION AND OPTIMIZATION OF PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR DISEASE

Background: Recent landmark trials have resulted in a paradigm shift in the management of patients with atherosclerotic cardiovascular disease (ASCVD), with emphasis on novel risk factor modification therapy. Complexity of these therapies for represents a challenge for clinicians and may lead to poor uptake of these therapies. In this study, we tested the longitudinal utility of an easy-to-use, point-of-care tool to provide education and guidance for management of ASCVD patients.

METHODS AND RESULTS: We previously designed an app for risk stratification and pharmacological optimization in ASCVD. Based on the REACH registry trial and predictive modeling (which included 49,689 patients), this tool was used to calculate an individual’s 20-month risk of cardiovascular events and mortality. Furthermore, we developed an algorithm for initiation of GDMT, based on a patient’s individual risk profile. Our application provided specific guidance for possible therapeutic interventions SGLT2-inhibitors, GLP1-agonists, PCSK9-inhibitors, vascular-dose Rivaroxaban, and Icosapent Ethyl. It also identified individuals who qualified for cardiac rehabilitation or may benefit from smoking cessation interventions, including counselling or pharmacological therapies. The “Residual Cardiovascular Risk: Assessment and Management Guide” application was assessed in a 3-month usability & feasibility trial. 240 referring physicians (including family physicians, emergency physicians, internists, and cardiologists) were invited to utilize the application. Feedback was solicited from all users after three. Among twenty-four physicians respondents to the survey after 3 months: 100% affirmed the functionality, ease of use, and utility of the tool. Following this initial testing period, no further marketing of the application was performed, and we tracked usage data was tracked over a 12-month period. From January 2021 to December 2021, our application was used to risk stratify 1576 patients (on average 131 times per month). A total of 367 individual users visited the site of whom 47 users regularly utilized the app.

Conclusion: Our application demonstrated sustained usage despite lack of marketing among physicians from varied background. In addition, it demonstrated subjective utility in aiding therapeutic decision making described as “useful for discussions with patients”, “helpful to optimize patients” and “similar to a mini-cardiology consult”. This suggests a high demand for physician-focused educational tools for secondary prevention of ASCVD. In subsequent iterations of this app, we plan to incorporate new guideline directed therapies including colchicine (based on the COLCOT study) and may include starting dosages for medications and Limited Use codes. Future clinical research will focus on the ability of this tool to impact physician prescribing patterns and clinical outcomes.