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In-hospital statin underutilization among high-risk patients: delayed uptake of the 2013 cholesterol guidelines in a

Subeer K Wadia1, Mark Belkin2, Kelsey S Chow3

  • 1a Department of Internal Medicine , Ronald Reagan UCLA Medical Center , Los Angeles , CA , USA.

Hospital Practice (1995)
|January 18, 2017
PubMed

Insights

High-intensity statin use in hospitalized high-risk cardiovascular patients is low and varies by medical specialty. Cardiology specialists prescribed high-intensity statins most frequently, highlighting opportunities for quality improvement interventions.

Area of Science:

  • Cardiology
  • Clinical Pharmacy
  • Healthcare Quality Improvement

Background:

  • Clinician adherence to 2013 cholesterol-lowering guidelines is inconsistent.
  • Understanding statin prescribing patterns among specialists treating high-risk cardiovascular patients is crucial.

Purpose of the Study:

  • To examine and compare statin prescribing patterns across different medical specialties.
  • To evaluate the utilization of high-intensity statins in high-risk cardiovascular patients post-guideline release.

Main Methods:

  • Retrospective chart review of 632 adult patients across Cardiology, CV Surgery, Neurology, and Internal Medicine.
  • Analysis of high-intensity statin (atorvastatin 40-80mg, rosuvastatin 20-40mg) prescribing at 6 and 18 months post-2013 guidelines.
  • Inclusion criteria: acute coronary syndrome, post-cardiac surgery, carotid procedures, stroke, TIA, or high-risk chest pain.

Main Results:

  • Overall high-intensity statin discharge rates were: Cardiology (80%-85%), CV Surgery (52%-65%), Neurology (59%-66%), and Internal Medicine (45%-48%).
  • Cardiology demonstrated significantly higher high-intensity statin use compared to other specialties (p < 0.001).
  • Cardiology, CV Surgery, and Neurology showed significant increases in high-intensity statin use from admission to discharge.

Conclusions:

  • High-intensity statin therapy is underutilized in hospitalized high-risk cardiovascular patients.
  • Significant variations in statin prescribing exist among different medical specialties.
  • Findings support the development of quality improvement interventions to enhance statin utilization in this population.
Abstract

Keywords:
Statinguidelinehigh-intensityinpatient

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