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A Retrospective Audit of Statin Prescription Practices in Diabetic Patients With Cardiovascular Risk
Muhammad Adnan Khaliq1, Sabih Nofal2, Samia Israr3
1Internal Medicine, Services Hospital, Lahore, PAK.
Insights
Diabetic patients often don't receive guideline-recommended statin therapy, leading to underuse and suboptimal dosing, particularly in women and younger individuals. Improving adherence is crucial for preventing cardiovascular disease in this high-risk population.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Diabetic patients face elevated cardiovascular disease (CVD) risk.
- Guidelines recommend statin therapy for most diabetics aged ≥40 or with established atherosclerotic CVD (ASCVD).
Purpose of the Study:
- To audit adherence to guideline-based statin prescribing for diabetic patients with cardiovascular risk.
- To identify gaps in statin prescription intensity and eligibility.
Main Methods:
- Retrospective audit of 131 diabetic patients' medical records.
- Data collected included demographics, diabetes duration, comorbidities, lipid profiles, CVD history, and statin prescription details.
Main Results:
- 83.2% of diabetic patients were eligible for statin therapy; 77.1% received statins, but 22.9% remained untreated.
- High-intensity statins were prescribed in only 33.3% of eligible cases.
- Statin use was lower in females (69.2%) vs. males (83.8%) and younger patients.
Conclusions:
- Significant underutilization and suboptimal dosing of statins observed in diabetic patients.
- Gaps in adherence are notable, especially for women and younger individuals.
- Enhanced clinical adherence strategies are needed to improve CVD outcomes.
Abstract:
Background Diabetic patients are at increased risk of cardiovascular disease (CVD), and clinical guidelines recommend statin therapy for most individuals with diabetes aged ≥40 years or those with established atherosclerotic CVD (ASCVD). Objective The main objective of this audit was to evaluate the adherence to guideline-based statin prescribing practices among diabetic patients with cardiovascular risk and to identify gaps in prescription intensity and eligibility. Materials and methods A retrospective clinical audit was conducted on 131 diabetic patients at a tertiary care center. Data were collected retrospectively through a structured audit tool using patient medical records, including demographics (age, sex), duration of diabetes, comorbidities, lipid profile reports, cardiovascular history, and current statin prescription status (type, dose, and intensity). Results Out of 131 diabetic patients, 109 (83.2%) were eligible for statin therapy. Among them, 84 (77.1%) received any statin, while 25 (22.9%) remained untreated despite eligibility. High-intensity statins were prescribed in only 28 (33.3%) cases. Among patients with ASCVD (n = 34), 85.3% were on statins, but only 55.9% received high-intensity therapy. In patients without ASCVD but with risk factors (n = 75), 73.3% received statins, mostly moderate-intensity. Statin use was significantly higher in males (83.8%) than in females (69.2%) (p = 0.041), and patients aged ≥50 were more likely to receive statins (p = 0.018). Conclusions This audit reveals underutilization and suboptimal dosing of statins in diabetic patients, especially among women and younger individuals. Strengthening clinical adherence through guideline dissemination, audit-feedback cycles, and electronic decision support systems may improve cardiovascular outcomes in this high-risk group.
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Pharmacovigilance
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...