Meghan B Brennan1, Elbert S Huang2, Jennifer M Lobo3, Hyojung Kang4, Marylou Guihan5, Anirban Basu6, Min-Woong Sohn7. 1. Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. Electronic address: mbbrennan@medicine.wisc.edu. 2. Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA. Electronic address: ehuang@medicine.bsd.uchicago.edu. 3. Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA. Electronic address: jem4yb@eservices.virginia.edu. 4. Department of Systems and Information Engineering, School of Engineering, University of Virginia, Charlottesville, VA, USA. Electronic address: hk7z@virginia.edu. 5. Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: marylou.guihan@va.gov. 6. Departments of Biostatistics and Health Services, School of Public Health, University of Washington, Seattle, WA, USA. Electronic address: basua@uw.edu. 7. Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA. Electronic address: msohn@virginia.edu.
Abstract
AIM: Statins reduce morbidity and mortality among patients with diabetes, but their use remains suboptimal. Understanding trends in statin use may inform strategies for improvement. METHODS: We enrolled a national, retrospective cohort of 899,664 veterans aged≥40years with diabetes in 2003. We followed them through 2011, dividing the nine-year follow-up into 90-day periods. For each period, we determined statin use, defined as possession of ≥30-day supply. We examine factors associated with statin uptake among baseline non-users with a multivariate model. RESULTS: Baseline prevalence of statin use was 43%, increased by 1.8% per period (p for trend<0.001), and reached a maximum of ~59%. Statin use among non-Hispanic racial/ethnic minorities lagged behind their white counterparts. Among baseline non-users, statin use was 9% after Year 1 and reached 36% by Year 9. Factors associated with statin uptake included use of hypoglycemic agents, HbA1c between 7 and 8.9% (53-74mmol/mol), hypertension, heart failure, peripheral vascular disease, and Hispanic ethnicity. CONCLUSION: Statin use is slowly increasing among patients with diabetes, and at varying rates within subgroups of this population. Policies that prioritize these subgroups for statin promotion may help guide future, intervention-based research to increase compliance with current guidelines.
AIM: Statins reduce morbidity and mortality among patients with diabetes, but their use remains suboptimal. Understanding trends in statin use may inform strategies for improvement. METHODS: We enrolled a national, retrospective cohort of 899,664 veterans aged≥40years with diabetes in 2003. We followed them through 2011, dividing the nine-year follow-up into 90-day periods. For each period, we determined statin use, defined as possession of ≥30-day supply. We examine factors associated with statin uptake among baseline non-users with a multivariate model. RESULTS: Baseline prevalence of statin use was 43%, increased by 1.8% per period (p for trend<0.001), and reached a maximum of ~59%. Statin use among non-Hispanic racial/ethnic minorities lagged behind their white counterparts. Among baseline non-users, statin use was 9% after Year 1 and reached 36% by Year 9. Factors associated with statin uptake included use of hypoglycemic agents, HbA1c between 7 and 8.9% (53-74mmol/mol), hypertension, heart failure, peripheral vascular disease, and Hispanic ethnicity. CONCLUSION: Statin use is slowly increasing among patients with diabetes, and at varying rates within subgroups of this population. Policies that prioritize these subgroups for statin promotion may help guide future, intervention-based research to increase compliance with current guidelines.
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