Donald G Lamprecht1, Paul B Shaw2, Jordan B King3, Keri N Hogan4, Kari L Olson4. 1. Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, USA; University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA. Electronic address: don.g.lamprecht@kp.org. 2. Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, USA; University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; Regis University School of Pharmacy, Denver, CO, USA. 3. Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, USA. 4. Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, USA; University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Abstract
BACKGROUND: Although high-intensity statin therapy (HIST) is recommended for most patients between 21 and 75 years of age with atherosclerotic cardiovascular disease (ASCVD), several recent analyses examining contemporary statin use trends have identified a clinical care gap in the utilization of HIST. OBJECTIVE: The objective of this study was to assess secular trends in lipid management for patients with ASCVD enrolled in a clinical pharmacy program within an integrated health care delivery system. METHODS: We performed serial cross-sectional studies over time, comprising 18,006 adults with both acute and chronic ASCVD, to assess trends in statin use and low-density lipoprotein cholesterol (LDL-C) levels from 2007 to 2016. RESULTS: Although the use of statin therapy (any intensity) remained relatively consistent throughout the 10-year study period (89% in 2007, 87% in 2016), the proportion of patients receiving HIST increased over time (44% in 2007, 67% in 2016; P < .001 for trend). Population mean LDL-C levels ranged from 73 to 83 mg/dL with a downward trend over the 10-year study period (P < .001 for trend). By 2016, the proportion of patients attaining an LDL-C <100 mg/dL and <70 mg/dL was 85% and 54%, respectively. Nonstatin lipid-lowering therapy use decreased over the study period, which was primarily driven by decreased use of ezetimibe (24% in 2007, 2% in 2016; P < .001 for trend). CONCLUSIONS: Among adults with ASCVD enrolled in a clinical pharmacy cardiac risk reduction service, guideline-directed use of HIST significantly increased over the past 10 years and coincided with decreased population LDL-C levels.
BACKGROUND: Although high-intensity statin therapy (HIST) is recommended for most patients between 21 and 75 years of age with atherosclerotic cardiovascular disease (ASCVD), several recent analyses examining contemporary statin use trends have identified a clinical care gap in the utilization of HIST. OBJECTIVE: The objective of this study was to assess secular trends in lipid management for patients with ASCVD enrolled in a clinical pharmacy program within an integrated health care delivery system. METHODS: We performed serial cross-sectional studies over time, comprising 18,006 adults with both acute and chronic ASCVD, to assess trends in statin use and low-density lipoprotein cholesterol (LDL-C) levels from 2007 to 2016. RESULTS: Although the use of statin therapy (any intensity) remained relatively consistent throughout the 10-year study period (89% in 2007, 87% in 2016), the proportion of patients receiving HIST increased over time (44% in 2007, 67% in 2016; P < .001 for trend). Population mean LDL-C levels ranged from 73 to 83 mg/dL with a downward trend over the 10-year study period (P < .001 for trend). By 2016, the proportion of patients attaining an LDL-C <100 mg/dL and <70 mg/dL was 85% and 54%, respectively. Nonstatin lipid-lowering therapy use decreased over the study period, which was primarily driven by decreased use of ezetimibe (24% in 2007, 2% in 2016; P < .001 for trend). CONCLUSIONS: Among adults with ASCVD enrolled in a clinical pharmacy cardiac risk reduction service, guideline-directed use of HIST significantly increased over the past 10 years and coincided with decreased population LDL-C levels.
Authors: Adam J Nelson; Kevin Haynes; Sonali Shambhu; Zubin Eapen; Mark J Cziraky; Michael G Nanna; Sara B Calvert; Kerrin Gallagher; Neha J Pagidipati; Christopher B Granger Journal: J Am Coll Cardiol Date: 2022-05-10 Impact factor: 27.203
Authors: Jingzhi Yu; Ann A Wang; Lindsay P Zimmerman; Yu Deng; Thanh-Huyen T Vu; Yacob G Tedla; Nicholas D Soulakis; Faraz S Ahmad; Abel N Kho Journal: J Gen Intern Med Date: 2022-01-08 Impact factor: 6.473
Authors: Michele Wood; Thomas Delate; Sheila L Stadler; Anne M Denham; Leslie K Ruppe; Roseanne Hornak; Kari L Olson Journal: Pharm Pract (Granada) Date: 2019-05-29