BACKGROUND: The proper use of statins and aspirin decrease the risk of coronary heart disease (CHD) among patients with diabetes (DM) and hyperlipidemia. The purpose of this study was to analyze the time trends and determinants of prescribing statins and aspirin among patients with DM and hyperlipidemia in medical practice in Taiwan. METHODS: A cohort of 21,667 patients with DM and hyperlipidemia during the period from 1998 to 2006 was identified by using data of ambulatory care claims from Taiwan's National Health Insurance Database. The dataset was categorized into two equal calendar periods: Period 1 (September 1998-June 2002) and Period 2 (July 2002-April 2006). Multivariate logistic regression analyses were used to determine the independent determinants associated with receipt of lipid-lowering agents and aspirin among these patients. RESULTS: There were significant increases in the prescribing of statins (OR 1.78; 95% CI 1.66-1.91) and aspirin (OR 1.47, 95% CI 1.50-1.59) in Period 2 as compared with Period 1. Nevertheless, 30% of patients with coexisting CHD neither received statins nor aspirin. Only 15% to 25% of DM patients with hyperlipidemia and CHD received the combined treatment with aspirin and statin. In multivariate logistic regression, we found that women received aspirin less frequently than men. Old patients (>45 years) with concomitant CHD were more likely to receive statins and aspirin. CONCLUSION: Despite the increasing trend in the use of statins and aspirin in DM patients with hyperlipidemia in Taiwan, the improvements were at best modest, particularly for secondary prevention. Our data indicate the need for continued efforts to improve the utilization of these drugs in daily practice.
BACKGROUND: The proper use of statins and aspirin decrease the risk of coronary heart disease (CHD) among patients with diabetes (DM) and hyperlipidemia. The purpose of this study was to analyze the time trends and determinants of prescribing statins and aspirin among patients with DM and hyperlipidemia in medical practice in Taiwan. METHODS: A cohort of 21,667 patients with DM and hyperlipidemia during the period from 1998 to 2006 was identified by using data of ambulatory care claims from Taiwan's National Health Insurance Database. The dataset was categorized into two equal calendar periods: Period 1 (September 1998-June 2002) and Period 2 (July 2002-April 2006). Multivariate logistic regression analyses were used to determine the independent determinants associated with receipt of lipid-lowering agents and aspirin among these patients. RESULTS: There were significant increases in the prescribing of statins (OR 1.78; 95% CI 1.66-1.91) and aspirin (OR 1.47, 95% CI 1.50-1.59) in Period 2 as compared with Period 1. Nevertheless, 30% of patients with coexisting CHD neither received statins nor aspirin. Only 15% to 25% of DMpatients with hyperlipidemia and CHD received the combined treatment with aspirin and statin. In multivariate logistic regression, we found that women received aspirin less frequently than men. Old patients (>45 years) with concomitant CHD were more likely to receive statins and aspirin. CONCLUSION: Despite the increasing trend in the use of statins and aspirin in DMpatients with hyperlipidemia in Taiwan, the improvements were at best modest, particularly for secondary prevention. Our data indicate the need for continued efforts to improve the utilization of these drugs in daily practice.