Reducing Sex Disparities in Statin Therapy Among Female Veterans With Type 2 Diabetes and/or Cardiovascular Disease

Female veterans have higher rates of cardiovascular disease (CVD) compared with the civilian population. Medical management with statins (3-hydroxy-3-methyl-glutaryl-coenzmye A reductase inhibitors) is the cornerstone of lipid-lowering therapy and cardiovascular risk reduction. Despite eligibility, female veterans are less likely to receive statin therapy than their male counterparts. This project aimed to increase statin prescribing for female veterans with type 2 diabetes mellitus (T2DM) and CVD to reduce sex disparities.

The primary objective of this project was to increase statin prescribing among female veterans with T2DM and/or CVD to reduce cardiovascular risk. Secondary outcomes included increased pharmacogenomic testing and the assessment of pharmacogenomic results related to statin therapy. The Primary Care Equity Dashboard (PCED) was used to identify female veterans without a statin prescription. A clinical pharmacist practitioner (CPP) contacted those identified to offer statin therapy and pharmacogenomic testing.

Of the 129 contacted veterans, 31 (24.0%) had a non-US Department of Veterans Affairs (VA) statin prescription, 13 (10.1%) had an active VA statin prescription and 85 (65.9%) did not have a statin prescription despite their eligibility. Of the 85 veterans with no active statin therapy, 37 (43.5%) were initiated on a statin. The percentage of female veterans with an active statin prescription increased from 77.8% to 79.0% for those with T2DM and from 82.2% to 90.2% for those with CVD. Seventy-one veterans agreed to pharmacogenomic testing, and 47 completed testing. Five patients had abnormal results that may impact statin tolerability.

The percentage of female veterans with T2DM and/or CVD with a statin prescription increased following CPP outreach. Pharmacogenomic testing should be used for statin prescribing and adherence.