1-3 The American College of Cardiology (ACC)-American Heart Association (AHA) updated the ATP guidelines in 2013. The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III ) has been issuing guidelines since 1988, and its last report was in 2004. Statins are recommended for the lowering of serum cholesterol levels in individuals at risk for, or who have, atherosclerotic cardiovascular disease (ASCVD). The identification of the use of statins outside established guidelines represents an opportunity to improve the quality and value of healthcare delivery.
SMART REMINDER CONCORDANCE HEALTH PROFESSIONAL
Veterans are commonly prescribed statins for indications not supported by professional society guidelines.Despite being commonly prescribed, little is known about indications for new statin prescriptions.We found that statins are often prescribed for indications not supported by either the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) or the American College of Cardiology-American Heart Association 2013 guidelines. New statin prescriptions at the Veterans Health Administration were reviewed using a cross-sectional study design. The finding of common use of statins outside established guidelines represents an opportunity to improve the quality and value of the healthcare delivery.Īm J Manag Care. Overall, approximately 19% of patients may have received a statin for an indication not supported by either guideline.Ĭonclusions: Veterans are commonly prescribed statins for indications not supported by professional society guidelines. 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. Among new prescriptions, 68% were prescribed for primary prevention and 32% were prescribed for secondary prevention. Results: We identified 250,243 new statin prescriptions in 2012 in the VHA, with 121,081 meeting inclusion criteria. 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. Methods: We identified every patient who received a new prescription (no statin use in the prior year) in the VHA in 2012. 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. Despite the prevalence of statin use, little is known about the indications for new prescriptions. Objectives: Statins are recommended to reduce serum cholesterol in patients at risk for atherosclerotic cardiovascular disease.
0 kommentar(er)
