Utilization and adherence to guideline-recommended lipid-lowering therapy at an academic medical center

Ann Saudi Med. 2017 Jul-Aug;37(4):276-281. doi: 10.5144/0256-4947.2017.276.

Abstract

Background: Clinical guidelines for managing blood cholesterol were updated in November 2013.

Objective: To evaluate the adherence to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations for statin therapy in the treatment of elevated blood cholesterol in high-risk patients.

Design: A single-center, retrospective, observational study.

Setting: A tertiary care academic medical center in Riyadh, Saudi Arabia.

Patients: Consecutive adult patients discharged with a prescription for any of the statin medications group between 1 June 2015 and 31 December 2015.

Main outcome measure(s): Adherence to the 2013 ACC/AHA guidelines for management of cholesterol by statin therapy in high-risk patients.

Results: Of 1094 patients, 753 (68.8%) met the inclusion criteria of the study. Of these 753 patients, 53.5% had atherosclerotic cardiovascular diseases; 29.2% had diabetes; 0.9% had an LDL-C level > 190 mg/dL; 10.8% had an estimated 10-year risk > 7.5%; and 4.9% had no risk. Two hundred and eight (27.6%) patients received statin therapy at an inappropriate intensity according to their risk group based on the guideline; 126 (16.7%) received less than the ideal intensity.

Conclusion: Approximately one-third of patients received statin therapy at an inappropriate intensity according to the guideline recommendation. Wide application of the 2013 ACC/AHA cholesterol guidelines in our practice would optimize the utilization of statin therapy at the ideal intensity in high-risk patients.

Limitation: Drug-drug interactions and intolerance to statin therapy were not considered when we evaluated adherence among high-risk patients.

Publication types

  • Observational Study

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Cholesterol / blood
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / standards*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / drug therapy
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy*
  • Lipids / blood
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Saudi-Arabien

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Cholesterol