NLA Awareness & Leadership Development – A Year in Review

President of the National Lipid Association for the past year. Thank you to this wonderful organization for allowing me to achieve many of the goals we set for the 2018-2019 year. As you will read below, the theme for my Presidency continues to be leadership development and organizational awareness – two goals I know Antonio Gotto, Jr. MD, DPhil, FNLA will continue to foster during his term. I am thrilled to share the work of the continuously advancing NLA, accomplished by the hard work of the talented members of the NLA councils, committees, task forces, work groups and staff.

Strategic Planning Goals

In January 2019, the NLA Executive Committee and leadership from the American Board of Clinical Lipidology (ABCL) and Accreditation Council for Clinical Lipidology (ACCL) met in Orlando, Florida for the NLA’s annual strategic planning meeting. In March, the NLA Board of Directors approved the 2019 strategic plan, which provides the following goals for the NLA, ABCL and ACCL:

• The NLA will pursue CMS recognition;
• The ABCL will continue to pursue ABIM recognition through a pathway of Focused Practice;
• The ACCL will develop a plan to modify pricing of the CLS exam and review eligibility requirements for each discipline;
• The ACCL will outline a pathway to offer the CLS credential to ABCL Diplomates;
• The ACCL will pursue an international audience for the CLS credential.

Recognition of Lipidology & Lipid Specialist Campaign - NLA Awareness

Formal recognition of Clinical Lipidology as a field of medicine has been goal of the National Lipid Association (NLA) since its inception in 2002. More than 1,000 health care professionals have achieved certification in the past decade by either ABCL or ACCL. What has been lacking is consistent nomenclature to identify these health care professionals to the public as the leading experts in the field of Clinical Lipidology. To further such recognition and create a viable pathway towards formal recognition of the specialty, the NLA Board of Directors, with the support of the ABCL and ACCL have adopted "Lipid Specialist" as its official term to be used in recognition efforts and in discussions with the public at large. A Lipid Specialist is defined as a healthcare professional certified by the American Board of Clinical Lipidology (ABCL) or Accreditation Council for Clinical Lipidology (ACCL) specializing in the identification and management of dyslipidemia and related metabolic disorders which lead to atherosclerotic cardiovascular disease (ASCVD) and other morbidities.

The NLA is pursuing the recognition of a provider taxonomy code through the Centers for Medicare and Medicaid Services (CMS) using the newly defined term. CMS recognition benefits those who meet the criteria to bill CMS for services as a Lipid Specialist. The NLA will lead the effort towards CMS recognition with the support of the ABCL and ACCL. The application to CMS is expected in 2020 with a final decision in 2021.

Since the March Board of Directors meeting, we have planned for the Lipid Specialist campaign to launch at the 2019 Scientific Sessions, designed to celebrate the Lipid Specialist. Celebrate the term Lipid Specialist with us at the Scientific Sessions and for years to come.

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"We are excited to share that the NLA will announce several new initiatives over the next year to enhance the benefits and offerings of our growing organization."

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Use of Lipoprotien(a) in Clinical Practice: A Biomarkers Whose Time Has Come - NLA Awareness

Within the last eighteen months, the NLA has developed a Scientific Statements Committee, prioritized a series of issues, and will publish its first Scientific Statement from the Scientific Statements Committee on the Use of Lipoprotien(a) in Clinical Practice: A Biomarkers Whose Time Has Come. A Scientific Statement of the NLA. The statement was recently approved for publication by the NLA Board of Directors.

Thank you to Don Wilson, MD, FNLA for chairing this effort and Terry A. Jacobson, MD, FNLA, Peter Jones, MD, FNLA, Marlys L. Koschinsky, PhD, FNLA, Catherine McNeal, MD, PhD, FNLA, Borge G. Nordestgaard, MD, DMSc and Carl E. Orringer, MD, FNLA for their work on behalf of the National Lipid Association. Projects of the NLA Scientific Statements Committee will continue to increase awareness of the NLA by clinicians, media, partner organizations and patients.

Enhancing the Value of PCSK9 Monoclonal Antibodies by Identifying Patients Most Likely to Benefit - NLA Awareness

Additionally, and as part of the NLA’s Guideline dissemination activities, the NLA developed a statement on the value of PCSK9 inhibitors in light of the most up to date cost of these agents. The statement provides updated guidance to the clinician for enhancing the value of alirocumab and evolocumab in clinical practice based on the most updated costs of these agents and advocates for decreased access barriers for patient groups with the greatest likelihood of improved clinical outcomes and costeffectiveness.

Thank you to Jennifer Robinson, MD, FNLA for chairing this project and Manju Bengularu Jayanna, MBBS, Karen Aspry, MD, FNLA, Carl Orringer, MD, FNLA, Edward A. Gill, MD, FNLA, Anne Goldberg, MD, FNLA, Laney Jones, PharmD, Kevin Maki, MD, PhD, FNLA, Dave Dixon, PharmD, Joseph Saseen, PharmD, FNLA and Daniel Soffer, MD, FNLA for working with me in authoring this manuscript on behalf of the NLA.

Upcoming Manuscripts - NLA Awareness

Awareness of the NLA and its membership should continue to grow with the several future NLA manuscripts and projects:

• Low Carb-High Fat/Ketogenic Diet led by Carol Kirkpatrick, PhD, MPH, RDN, CLS, FNLA - anticipated Fall 2019
• Lipid Laboratory Testing led by Peter Wilson, MD, FNLA - anticipated Fall 2019
• Genetic Testing led by Marina Cuchel MD, PhD and Rob Hegele, MD, FRCPC - anticipated Spring 2020
• ASCVD in the South Asian Population led by Dinesh Kalra, MD – anticipated Spring 2020

New Working Groups - Leadership

NLA work groups exist to provide opportunity for NLA involvement in focused areas of practice or interest. The work groups set their own agenda within the scope of NLA priorities and can bring forward ideas for national projects. For more information on NLA work groups, visit lipid.org/about/committees/ workinggroups. Over the past year, the NLA has added several new work groups to help address scientific needs:

South Asian Work Group - Leadership

to be very active in a short period of time. Led by Kris Vijay, MD, FNLA and Geeta Sikand, RD, MA, CLS, FNLA, the South Asian Work Group has prioritized a member needs survey and manuscript on the treatment of dyslipidemia in South Asian patients as goals for 2019. Stay tuned for these exciting outputs.

Peripheral Artery/Vascular Disease Work Group - Leadership

The Peripheral Artery/Vascular Disease Work Group was started in April 2019 and will be led by Marc Bonaca, MD. If you are interested in joining this work group, please contact NLA staff at exec@lipid.org.

Imaging Work Group

The Imaging Work Group was started in April 2019 and will be led by Matt Budoff, MD. If you are interested in joining this work group, please contact NLA staff at exec@lipid.org.

Guidelines Dissemination Activities - NLA Awareness

The NLA’s organizational partner in the development of the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol continues to provide opportunities for the NLA to step out front and provide important education and publications. Thank you to Karen Aspry, MD, FNLA for her continued Guideline dissemination activities. In the past 6 months, the NLA has held or executed the following activities:

• "Practice Cholesterol Guidelines Education for the Primary Care Provider." - Dan Soffer, MD, FNLA and Margo Minissian, ACNP, CLS at Pri-Med South
• "New Dyslipidemia Guidelines: Expert Evaluation and Implications for Clinical Care" - Alan Brown, MD, FNLA, Joseph Saseen, PharmD, FNLA, and James Underberg, MD, FNLA
• Updated curriculum in the Foundations of Lipidology and Masters in Lipidology courses
• Scientific programming at the Spring Clinical Lipid Update and Scientific Sessions
• Updated Core Curriculum

Look for even more Guideline dissemination activities from the NLA over the next 12 months, including enduring components of activities you may have missed and an NLA member slide deck.

Rising Leaders in the Organization - Leadership

Over the course of the last year, I wanted to prioritize mentorship and leadership development of rising NLA members. Congratulations to many of these individuals for excellence during the 2018-2019 year:

• Marc Bonaca, MD for his willingness to lead the new Peripheral Artery/Vascular Disease Work Group
• Mary Katherine Cheeley, PharmD, FNLA for her participation in the STatin Adverse Treatment Experience (STATE) Survey project
• Nihar Desai, MD, MPH for his participation in the South Asian Work Group, 2019 Strategic Planning, and the NLA Guidelines dissemination activities
• Dinesh Kalra, MD for his participation in the South Asian Work Group
• Nataliya Pyslar, MD for her participation in the NLA Guidelines dissemination activities

Membership Consultant - NLA Awareness

Finally, to continue to improve the recruitment and retention efforts of the NLA, the organization is utilizing a membership consultant to hear from its members. We are excited to share that the NLA will announce several new initiatives over the next year to enhance the benefits and offerings of our growing organization.

I would like to thank the membership, the Board of Directors and staff for the support provided over the past year. This organization continues to move forward, and I know that the Board of Directors and staff will continue the great momentum towards greater NLA awareness and leadership development.

Disclosure statement: Dr. Brown has served as Consultant for Akcea, Amgen, Kowa, Regeneron and Sanofi.