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An Evaluation of the Factors Associated with Statin Dose Management and Low-Density Lipoprotein-Cholesterol Goal Attainment

  • Original Research Article
  • Published:
Disease Management & Health Outcomes

Abstract

Purpose

To examine factors associated with HMG-CoA reductase inhibitor (statin) management and the effect of therapeutic modifications on patients’ abilities to reach their low-density lipoprotein-cholesterol (LDL-C) goal in a sample of managed care enrollees.

Methods

This retrospective analysis utilized electronic pharmacy claims, medical claims, and laboratory data, and explored the occurrence and magnitude of modifications to statin regimens. Patients aged ≥18 years who were initiated on statin therapy between 1 January 2001 and 31 December 2001 and who were continuously enrolled for 6 months prior to and 12 months following the index prescription were included. A subgroup analysis incorporated laboratory data to determine whether patients attained their LDL-C treatment goal.

Results

A total of 38 567 patients were identified: 50.6% were female and patients had a mean age of 63.6 ±13.4 years. During a 1-year follow-up, 16.1% (n = 6220) had a modification to their statin regimen. Multivariate analysis showed that significant predictors of regimen modification included age, sex, index statin, index statin potency, and the occurrence of a cardiac reperfusion procedure or acute hospitalization during the 6-month pre-index period (p < 0.05). A subgroup of 254 patients with laboratory data was identified: 57.9% of these patients were female and their mean age was 66.6 ± 10.5 years. Of this cohort, only 14.2% had a modification to their statin regimen. Goal attainment was significantly more frequent among patients whose statin regimen was modified compared with patients whose statin regimen was not modified (72.2% vs 52.8%; p = 0.0294).

Conclusion

The low occurrence of therapeutic modifications and goal attainment may indicate a need for greater awareness of the importance of effective statin use.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgments

This research was funded by AstraZeneca LP, Wilmington, Delaware, USA. The research in this manuscript was conducted by researchers from the Pharmacoeconomics and Health Outcomes Research Department of Prescription Solutions®, a pharmacy benefit and medical management company in Costa Mesa, California, USA and the Health Economics and Outcomes Research Department of AstraZeneca LP.

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Authors and Affiliations

  1. Prescription Solutions, Health Economics and Health Outcomes Research, 3515 Harbor Blvd, Mail Stop LC07-264, Costa Mesa, California, CA 92626, USA

    Caron Ory (Researcher), Christina Fontes & Eunice Chang

  2. AstraZeneca LP, Wilmington, Delaware, USA

    Setareh A. Williams, Gerald M. Borok & Kenneth McDonough

Authors
  1. Caron Ory
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  2. Christina Fontes
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  3. Setareh A. Williams
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  4. Gerald M. Borok
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  5. Kenneth McDonough
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  6. Eunice Chang
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Correspondence to Caron Ory.

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Ory, C., Fontes, C., Williams, S.A. et al. An Evaluation of the Factors Associated with Statin Dose Management and Low-Density Lipoprotein-Cholesterol Goal Attainment. Dis-Manage-Health-Outcomes 14, 37–44 (2006). https://doi.org/10.2165/00115677-200614010-00005

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  • DOI: https://doi.org/10.2165/00115677-200614010-00005

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