Published online Aug 26, 2020. doi: 10.4330/wjc.v12.i8.419
Peer-review started: February 28, 2020
First decision: April 25, 2020
Revised: May 13, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: August 26, 2020
Statins have an important and well-established role in the prevention of atherosclerotic cardiovascular disease (ASCVD). However, several studies have reported widespread underuse of statins in various practice settings and populations.
Review of relevant literature reveals opportunities for improvement in the implementation of guideline-directed statin therapy (GDST).
In this study, we aimed to examine the impact of cardiologist intervention on the use of statin therapy in the ambulatory setting.
We conducted a retrospective chart review of patients who had at least one encounter at the adult Internal Medicine Clinic (IMC) and/or Cardiology Clinic (CC) and who had an available serum cholesterol test performed. The 2 comparison groups were defined as: (1) Patients only seen by IMC; and (2) Patients seen by both IMC and CC. Baseline characteristics of subgroups were compared.
A total of 268 patients met the inclusion criteria for this study. Approximately, 14% had clinical ASCVD, 13% were current smokers, 66% were diabetic, and 63% were hypertensive. Statin use was observed in 55% of the entire cohort, with moderate- intensity statins being the most commonly prescribed. Overall, in the IMC-CC group, 73.6% of patients were prescribed statin therapy compared to 50.7% of patients in the IMC group. There was no statistical difference in the use of GDST between groups.
Our study compared the use of GDST in patients managed by general internists and those co-managed by a cardiologist. Overall, statin use in this population is comparable to what other studies have shown and highlights the need to design and implement strategies to improve prescriber adherence to GDST.