HOUSTON—Statin use remains suboptimal in patients with atherosclerotic cardiovascular disease, according to a VA study trying to find out why.
Michael E. DeBakey VAMC researchers and colleagues assessed whether outpatient care with a cardiology provider is associated with evidence-based statin prescription and statin adherence. Results were published in the American Journal of Cardiology.1
For the study, the team identified adults with ASCVD receiving primary care in 130 facilities and associated community-based outpatient clinics in the entire VA Health Care System between Oct. 1, 2013, and Sept. 30, 2014.
Participants were divided into either a group including patients with at least one outpatient cardiology visit or a group including patients with no outpatient cardiology visits in the year before the index primary care visit.
Researchers also assessed any- and high-intensity statin prescription, adjusting for several patient- and facility-level covariates,and statin adherence using proportion of days covered. Included were more than 1.2 million patients with ASCVD; the mean age was 71.9%, and the group was 98% male.
Results indicated that, after adjusting for covariates, patients who visited a cardiology provider had greater odds of being on a statin (87.4% vs. 78.4%; Odds ratio [OR] 1.25, 95% Confidence interval [CI] 1.24 to 1.26), high-intensity statin (34.5% vs. 21.2%; OR: 1.21, 95% CI 1.21 to 1.22) and higher statin adherence (mean PDC 0.76 ± 0.29 vs. 0.70 ± 0.34, PDC ≥0.8: 62.0% vs. 57.3%; OR 1.09, 95% CI 1.09 to 1.11).
“A dose response relation was seen with a higher number of cardiology visits associated with a higher statin use and statin adherence,” the study authors wrote. “In conclusion, compared with outpatient care delivered by primary care providers alone, care delivered by a cardiology provider for patients with ASCVD is associated with a higher likelihood of guideline-based statin use and statin adherence.”
1. Rehman H, Ahmed ST, Akeroyd J, Mahtta D, et. Al. Relation Between Cardiology Follow-UpVisits, Evidence-Based Statin Prescribing, and Statin Adherence (from theVeterans Affairs Health Care System). Am J Cardiol. 2019 Jul 25. pii:S0002-9149(19)30819-7. doi: 10.1016/j.amjcard.2019.07.022. [Epub ahead of print] PubMed PMID: 31405545.