These findings validate the forecasts of the Archimedes Model. The Archimedes Model simulated the pathophysiology, treatments, and outcomes of coronary artery disease and diabetes and its complications at the individual level and aggregated the results to project population-level effects. The model forecasted that "bundled" cardioprotective medications aspirin, lisinopril, and lovastatin would reduce the risk of heart attack and stroke in a high-risk population by 71 percent. In 2002 Kaiser Permanente researchers used the Archimedes Model to project the effects of offering the combined pharmacotherapy and to develop a simple, inexpensive method for delivering it.

The Kaiser Permanente researchers conducted this observational study of its drug-bundling program as a clinical execution of the Archimedes modeling because the simulation model outcomes looked so promising, researchers said.

"The program's results confirm the Archimedes Model's predictions that these treatments can save lives and reduce health care costs," said David Eddy, MD, Ph.D., founder and chief medical officer emeritus of Archimedes, Inc.

Currently more than 256,000 Kaiser Permanente members in Hawaii, California, Oregon, Washington, Colorado, Ohio, Georgia, Maryland, Virginia, and Washington, D.C. are participating in the drug medication bundle program. Clinicians use Kaiser Permanente HealthConnect?®, the world's largest civilian electronic health records system, to find high-risk patients not already on the medications and use the health provider's integrated delivery system to reach out to eligible members at every point of care.

As an example of how this program can be widely implemented in diverse populations and health care settings, this initiative has also been applied in community health centers through Kaiser Permanente's community benefit program. In underserved populations with varying levels of health literacy, the number of patients taking the bundle increased fourfold within a 12-month period.

"We have long known from clinical trials that aspirin, cholesterol-lowering therapies such as statins, and ACE inhibitors such as lisinopril reduce the risk of future heart attacks and strokes in patients who have had a prior cardiovascular event or who have diabetes. Our primary goal here was to increase the use of the drugs," said study co-author Jim Bellows, Ph.D., Kaiser Permanente Care Management Institute's director of the Center for Evaluation and Innovation. Bellows helped develop the evaluation of the program to bundle and deliver the two medications.

SOURCE Kaiser Permanente