Facilitating Clinical Research through the Health Information Exchange: Lipid Control as an Example.

Using data from the Indiana Network of Patient Care (INPC), we analyzed long-term statin adherence patterns and their effects on low-density lipoprotein cholesterol (LDL-C) control among patients with type 2 diabetes. Statin adherence was measured by proportion of days covered (PDC) for a 6-month interval prior to each LDL-C test date. Patient demographic and clinical characteristics were used as covariates for LDL-C control and predictors for statin adherence. From 4,350 eligible subjects, 25,596 6-month PDC and LDL-C level pairs were formed between 2001 and 2009. Rates of suboptimal adherence and suboptimal LDL-C control were 68.5% and 46.6%, respectively. Positive predictors for LDL-C control included adherence to statin (OR: 1.87, p<0.0001) and older age (OR: 1.11, p=0.01). Significant risk factors for non-adherence were young age, female gender, African American race and newly-treated status. This study demonstrated the utility of a health information exchange in health outcome and clinical effectiveness research.