Utilizing Electronic Health Record–Based Alerts to Increase Prescription of Lipid-Lowering Therapies in Patients Admitted With Acute Coronary Syndromes

BACKGROUND: Patients hospitalized with acute coronary syndromes (ACS) are at high risk of recurrent events, yet lipid-lowering therapy is often underutilized despite strong guideline recommendations. PROJECT RATIONALE: To address treatment gaps, we implemented a real-time electronic health record (EHR) alert prompting optimization of lipid-lowering therapy for patients hospitalized with ACS. PROJECT SUMMARY: An interruptive EHR alert, triggered on ACS admission, encouraged statin intensification or ezetimibe initiation. Among 612 patients from 2021 to 2025, 20.6% of alerts were accepted. Therapy was intensified in 61.3% of patients overall. In addition, 6-month preintervention data suggested significant increases in both ezetimibe prescribing (3.3% increasing to 13.7%, P = 0.002) and statin prescribing or intensification (44.9% increasing to 55.1%, P = 0.016) following the implementation of the EHR alert. TAKE-HOME MESSAGE: Real-time EHR alerts can prompt both direct and indirect lipid therapy intensification in ACS care, improving adherence to guideline-directed lipid-lowering therapy and promoting more effective secondary prevention.