VALOR-QI cholesterol management program improves Veterans’ health

In partnership with the American Heart Association (AHA), the VA Lipid Optimization Reimagined - Quality Improvement (VALOR-QI) program has helped more than 70,000 Veterans at 50 VA locations across the country and continues to help them lower their cholesterol and improve their cardiovascular health every day.

Specifically, VALOR-QI is designed to improve the treatment of high cholesterol in Veterans with atherosclerotic cardiovascular disease (ASCVD), who are often at a high risk of heart attack or stroke. Since March 2023, the program has helped Veterans by increasing cholesterol monitoring, providing education on managing cholesterol through medication and lifestyle changes, and improving clinical care through a multi-disciplinary team approach. More than 600 VA clinical staff are involved in the effort.

"Despite existing attempts to control cholesterol, there is still a significant population-level gap between what most ASCVD patients experience and what we believe is possible," said Dr. Carolyn Clancy, VA assistant undersecretary for Discovery, Education, and Affiliated Networks. "VALOR-QI aims not only to improve treatment for ASCVD, but also to redouble our efforts to find ways to overcome barriers to health equity for all Veterans."

Preliminary results show a 7% increase in the proportion of Veterans achieving the goal for low-density lipoprotein cholesterol (LDL-C, the so-called "bad cholesterol"). This improvement reduces the risk of heart attack, stroke, and cardiovascular disease-related death.

As a quality improvement initiative, VALOR-QI not only provides direct support to Veterans but also helps optimize VA's clinical care and address barriers to care faced by some Veterans. The program uses specialized training from AHA and employs a new position called the Healthcare Coach to educate and assist Veterans on managing their high cholesterol and seeking appropriate care.

Participating VALOR-QI sites also undergo rigorous evaluation to assess how well they are managing patients' ASCVD, and program staff are working to address health equity gaps related to sex, race, ethnicity, and other factors.

"This partnership between VA and AHA has built the capacity to continue the fight on what remains a major problem for U.S. Veterans," said Dr. Rachel Ward, director of VA's Partnership Program.

Cardiovascular disease remains the number one cause of death in the United States and is a leading cause of hospitalization among Veterans in the VA health care system. Cholesterol management - modifying diet and exercise, along with medication - is one of the best ways to lower the risk of heart attack, stroke, and death from cardiovascular disease. By giving Veterans and health care providers the tools to better manage high cholesterol, VALOR-QI is making a real difference in Veterans' lives.