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Increase in lipid-lowering treatment rates among TRICARE beneficiaries: a population-based study
Joshua Devine1, Andrea Linton, Harsha Mistry
1Department of Defense Pharmacoeconomic Center, Fort Sam Houston, TX 78234, USA. josh.devine@amedd.army.mil
Insights
Lipid-lowering treatment (LLT) use increased significantly in high-risk cardiovascular disease (CVD) patients within the US Military Health System (MHS). Despite this growth, a substantial portion of high-risk individuals still do not receive necessary lipid-lowering medication.
Area of Science:
- Cardiovascular Medicine
- Pharmacotherapy
- Health Services Research
Background:
- Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality.
- Lipid-lowering treatment (LLT) is a cornerstone in managing CVD risk.
- Understanding LLT utilization patterns in healthcare systems is crucial for optimizing patient outcomes.
Purpose of the Study:
- To evaluate the utilization of lipid-lowering treatment (LLT) in patients at risk for cardiovascular disease (CVD) within the US Military Health System (MHS).
Main Methods:
- Analysis of healthcare service and prescription records for beneficiaries aged 18 years or older in 2002, 2004, and 2006.
- Categorization of patients based on cardiovascular (CV) risk levels.
- Logistic regression models used to estimate the odds of receiving LLT, adjusted for age, gender, and CV risk.
Main Results:
- Overall LLT prevalence increased from 9.3% in 2002 to 14.7% in 2006.
- Among patients with established coronary artery disease (CAD) or peripheral vascular disease (PVD), LLT use rose from 55% to 65%.
- Diabetic patients without coded CAD/PVD showed the largest relative increase in LLT use (47% to 66%).
Conclusions:
- The US Military Health System (MHS) demonstrated a significant increase in LLT for high-risk cardiovascular disease (CVD) patients.
- Despite the increase, LLT may still be underutilized, with approximately one-third of high-risk patients not receiving medication.
- Further efforts may be needed to ensure optimal LLT uptake in at-risk populations.
Purpose:
To evaluate the use of lipid-lowering treatment (LLT) among patients at risk for cardiovascular disease (CVD) in the US Military Health System (MHS).
Methods:
The study examined healthcare service and prescription records among beneficiaries > or =18 years for calendar years 2002, 2004, and 2006. Patients were categorized based on cardiovascular (CV) risk, with exposure to LLT defined as one or more prescriptions for lipid-lowering medication. Logistic regression models estimated odds of treatment in 2004 and 2006 relative to 2002 after adjustment for age, gender, and CV risk.
Results:
The yearly unadjusted population prevalence of LLT increased from 9.3% in 2002 to 14.7% in 2006. Among subjects with the highest CV risk, established coronary artery disease (CAD) or peripheral vascular disease (PVD), those receiving LLT increased from 55% in 2002 to 65% in 2006 (adjusted OR = 1.50, 95% CI 1.48, 1.52, p < 0.00). Treatment rates among diabetic patients with no coded CAD or PVD showed the largest relative increase from 47% in 2002 to 66% in 2006 (adjusted OR = 2.30, 95% CI 2.26, 2.332, p < 0.00). LLT growth was lowest among those with only 1 coded CV risk factor (adjusted OR = 1.32, 95% CI 1.31, 1.34, p < 0.00).
Conclusions:
The MHS experienced a significant increase in LLT among patients at greatest risk for cardiovascular disease. However, treatment may still be underutilized as approximately one-third of high-risk patients did not receive lipid-lowering medication.
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