Guideline concordance of new statin prescriptions

Who got a statin?

Thomas Cascino, Marzieh Vali, Rita Redberg, Dawn Bravata, John Boscardin, Elnaz Eilkhani, Salomeh Keyhani

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVES: Statins are recommended to reduce serum cholesterol in patients at risk for atherosclerotic cardiovascular disease. Despite the prevalence of statin use, little is known about the indications for new prescriptions. We assessed the concordance of new statin prescriptions in the Veterans Health Administration (VHA) compared with the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III) guidelines (the guidelines in force in 2012) and the American College of Cardiology (ACC)-American Heart Association (AHA) 2013 guidelines. STUDY DESIGN: Cross-sectional study. METHODS: We identified every patient who received a new prescription (no statin use in the prior year) in the VHA in 2012. Patients were excluded if they had incomplete data, triglycerides greater than 400 mg/dL, or fewer than 2 primary care visits to ensure adequate baseline data to calculate Framingham and ACC-AHA 2013 risk scores. RESULTS: We identified 250, 243 new statin prescriptions in 2012 in the VHA, with 121, 081 meeting inclusion criteria. Among new prescriptions, 68% were prescribed for primary prevention and 32% were prescribed for secondary prevention. Among patients receiving new statins for primary prevention, 48% did not have an indication supported by the ATP III guideline and 20% did not have an indication supported by the ACC/AHA guideline. Overall, approximately 19% of patients may have received a statin for an indication not supported by either guideline. CONCLUSIONS: Veterans are commonly prescribed statins for indications not supported by professional society guidelines. The finding of common use of statins outside established guidelines represents an opportunity to improve the quality and value of the healthcare delivery.

Original languageEnglish (US)
Pages (from-to)528-533
Number of pages6
JournalAmerican Journal of Managed Care
Volume23
Issue number9
StatePublished - Sep 1 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Prescriptions
Guidelines
Veterans Health
United States Department of Veterans Affairs
American Heart Association
Primary Prevention
Cardiology
Adenosine Triphosphate
Cholesterol
Quality of Health Care
Veterans
Secondary Prevention
Primary Health Care
Triglycerides
Cardiovascular Diseases
Cross-Sectional Studies
Delivery of Health Care

ASJC Scopus subject areas

  • Health Policy

Cite this

Cascino, T., Vali, M., Redberg, R., Bravata, D., Boscardin, J., Eilkhani, E., & Keyhani, S. (2017). Guideline concordance of new statin prescriptions: Who got a statin? American Journal of Managed Care, 23(9), 528-533.

Guideline concordance of new statin prescriptions : Who got a statin? / Cascino, Thomas; Vali, Marzieh; Redberg, Rita; Bravata, Dawn; Boscardin, John; Eilkhani, Elnaz; Keyhani, Salomeh.

In: American Journal of Managed Care, Vol. 23, No. 9, 01.09.2017, p. 528-533.

Research output: Contribution to journalArticle

Cascino, T, Vali, M, Redberg, R, Bravata, D, Boscardin, J, Eilkhani, E & Keyhani, S 2017, 'Guideline concordance of new statin prescriptions: Who got a statin?', American Journal of Managed Care, vol. 23, no. 9, pp. 528-533.
Cascino T, Vali M, Redberg R, Bravata D, Boscardin J, Eilkhani E et al. Guideline concordance of new statin prescriptions: Who got a statin? American Journal of Managed Care. 2017 Sep 1;23(9):528-533.
Cascino, Thomas ; Vali, Marzieh ; Redberg, Rita ; Bravata, Dawn ; Boscardin, John ; Eilkhani, Elnaz ; Keyhani, Salomeh. / Guideline concordance of new statin prescriptions : Who got a statin?. In: American Journal of Managed Care. 2017 ; Vol. 23, No. 9. pp. 528-533.
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AU - Eilkhani, Elnaz

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