Optimizing Care for Cardiovascular-Kidney-Metabolic Syndrome: Leveraging Implementation Science in the Path Toward Pharmacoequity.

PURPOSE OF REVIEW: Overview the current landscape of pharmacoequity in cardiovascular-kidney-metabolic (CKM) syndrome. RECENT FINDINGS: CKM syndrome is a key driver of the significant morbidity and mortality associated with cardiovascular disease, and poses a significant threat to public health. Despite a growing armamentarium of evidence-based therapies for the prevention and management of CKM syndrome, access to these treatments remains unequal. For instance, gender, race, and ethnicity-based disparities have been noted in use of first-line, guideline-directed, disease-modifying drugs. Barriers to pharmacoequity in CKM including multimorbidity/polypharmacy, low awareness, clinical inertia, cost, pharmacy inaccessibility, unequal socio-contextual factors, and fragmented care require urgent attention including equity-promoting policy.​​ Individual- and system-level barriers to pharmacoequity in CKM syndrome impede optimal CKM management, particularly among minoritized populations. We describe how a multifaceted, multi-level approach to CKM equity including interdisciplinary care and clinical decision support tools designed from an implementation science lens may help combat these inequities.

Duke Scholars

Author Dinushika Mohottige Medicine, Nephrology