CINEMA Program Tackles Therapeutic Inertia in Cardiometabolic Care Through Multi-faceted Approach
Key Insights
The CINEMA (search) program implements a comprehensive strategy featuring clinical pharmacist champions, weekly educational sessions, and patient assistance programs to overcome therapeutic inertia in cardiometabolic (search) care.
A team-based approach ensures patients receive and maintain guideline-directed therapies like SGLT2 inhibitors (search) and GLP-1 receptor agonists through regular monitoring and support.
The Cardiometabolic Center Alliance (search) is working to scale successful programs like CINEMA (search) across diverse healthcare settings, providing best practices and real-world data to support implementation.
The University Hospitals Harrington Heart & Vascular Institute (search) has developed an innovative approach to address therapeutic inertia in cardiometabolic (search) care through its CINEMA (search) program, implementing multiple strategies to ensure patients receive and adhere to evidence-based treatments.
Multi-faceted Strategy to Combat Therapeutic Inertia
At the core of the program is a clinical pharmacist champion who provides personalized medication education, counseling, and dose escalation support. These pharmacists maintain regular four-week check-ins with patients to address side effects, concerns, and ensure proper therapy adherence.
The program's comprehensive educational component includes weekly Monday classes covering various aspects of care, from medication management to foot care and nutrition. Additionally, Tuesday sessions feature chair exercise programs using resistance bands, creating multiple engagement points for patients through virtual platforms.
"Most of the patient's engagement actually occurs outside the office with our staff on a regular basis," explains Dr. Ian Neeland, director of cardiovascular prevention and codirector of CINEMA (search). "This helps people stay engaged and feel like they're heard and involved in their own care."
Addressing Access and Social Determinants
To overcome financial barriers, CINEMA (search) has established robust patient assistance programs, helping eligible patients obtain necessary medications and navigate insurance challenges. The program also employs community health workers to address social determinants of health that might impede care delivery.
Scaling Success Through Alliance Building
While the resource-intensive nature of CINEMA (search) presents scaling challenges, the program has joined forces with similar initiatives across the country through the Cardiometabolic Center Alliance (search). This collaboration aims to establish best practices and create a roadmap for successful implementation across diverse healthcare settings.
"The Cardiometabolic Center Alliance (search) has demonstrated that the scalability issue is a barrier, but can be overcome," notes Dr. Neeland. "These types of programs can be instituted across a wide range of institutions, both urban and rural, primary care practices and specialty practices, geographically diverse."
Keys to Program Success
The program's effectiveness relies on several critical factors:
- Institutional buy-in and support
- Dedicated champion leadership
- Adequate resource allocation
- Educational infrastructure
- Regular patient engagement
- Comprehensive support systems
Through these coordinated efforts, CINEMA (search) demonstrates how healthcare systems can effectively address therapeutic inertia and improve patient outcomes in cardiometabolic (search) care.