Evaluation of Adherence to current guidelines for treatment of hyperlipidemia in adults in an outpatient setting

Christina Ng, Philip Chung, Yuliana Toderika, Angela Cheng-Lai

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Adherence to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline at an outpatient clinic was evaluated. Methods: This retrospective chart review study was conducted from December 1, 2013, through November 30, 2014, at an urban outpatient clinic. Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was calculated based on the pooled cohort equation for all patients. Patients were categorized into one of four statin-benefit groups, in descending order of ASCVD risk. The recommended intensity of a statin and the therapeutic response were determined for each patient. If statin therapy was indicated, patients were assigned to the moderate-intensity, moderate- or high-intensity, or high-intensity group according to guideline recommendations. These guideline-recommended statin intensities were then compared to the patient's prescribed statin to determine guideline concordance. Therapeutic response, expressed as the percent decrease in low-density lipoprotein cholesterol, was determined based on recommended statin intensity. Results: A total of 255 patients were initiated on statin therapy; 193 were included for data analysis. Overall adherence to the guideline was 65.8%, with the highest rate in the group of patients with the lowest risk of ASCVD (97.8%). The group with the lowest rate of adherence to recommendations was patients with clinical ASCVD (46.9%). Only 31.6% of patients had a follow-up lipid panel performed, and even fewer achieved a therapeutic response. Conclusion: A majority of patients were initiated on the appropriate intensity of statin therapy according to the ACC/AHA cholesterol guideline. Of the small number of patients who had follow-up visits, few achieved a therapeutic response based on their prescribed statin therapy.

Original languageEnglish (US)
Pages (from-to)S133-S140
JournalAmerican Journal of Health-System Pharmacy
Volume73
Issue number23
DOIs
StatePublished - Dec 1 2016

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hyperlipidemias
Outpatients
Guidelines
Cardiovascular Diseases
Therapeutics
Ambulatory Care Facilities
Cholesterol
American Heart Association
Guideline Adherence
Cardiology
LDL Cholesterol
Lipids

Keywords

  • 2013 cholesterol guideline
  • ASCVD
  • Atherosclerotic cardiovascular disease
  • Guideline adherence
  • Hyperlipidemia
  • Statins

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology
  • Health Policy

Cite this

Evaluation of Adherence to current guidelines for treatment of hyperlipidemia in adults in an outpatient setting. / Ng, Christina; Chung, Philip; Toderika, Yuliana; Cheng-Lai, Angela.

In: American Journal of Health-System Pharmacy, Vol. 73, No. 23, 01.12.2016, p. S133-S140.

Research output: Contribution to journalArticle

@article{c48f860d4c494b0aad9446bf6c318f82,
title = "Evaluation of Adherence to current guidelines for treatment of hyperlipidemia in adults in an outpatient setting",
abstract = "Purpose: Adherence to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline at an outpatient clinic was evaluated. Methods: This retrospective chart review study was conducted from December 1, 2013, through November 30, 2014, at an urban outpatient clinic. Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was calculated based on the pooled cohort equation for all patients. Patients were categorized into one of four statin-benefit groups, in descending order of ASCVD risk. The recommended intensity of a statin and the therapeutic response were determined for each patient. If statin therapy was indicated, patients were assigned to the moderate-intensity, moderate- or high-intensity, or high-intensity group according to guideline recommendations. These guideline-recommended statin intensities were then compared to the patient's prescribed statin to determine guideline concordance. Therapeutic response, expressed as the percent decrease in low-density lipoprotein cholesterol, was determined based on recommended statin intensity. Results: A total of 255 patients were initiated on statin therapy; 193 were included for data analysis. Overall adherence to the guideline was 65.8{\%}, with the highest rate in the group of patients with the lowest risk of ASCVD (97.8{\%}). The group with the lowest rate of adherence to recommendations was patients with clinical ASCVD (46.9{\%}). Only 31.6{\%} of patients had a follow-up lipid panel performed, and even fewer achieved a therapeutic response. Conclusion: A majority of patients were initiated on the appropriate intensity of statin therapy according to the ACC/AHA cholesterol guideline. Of the small number of patients who had follow-up visits, few achieved a therapeutic response based on their prescribed statin therapy.",
keywords = "2013 cholesterol guideline, ASCVD, Atherosclerotic cardiovascular disease, Guideline adherence, Hyperlipidemia, Statins",
author = "Christina Ng and Philip Chung and Yuliana Toderika and Angela Cheng-Lai",
year = "2016",
month = "12",
day = "1",
doi = "10.2146/ajhp160050",
language = "English (US)",
volume = "73",
pages = "S133--S140",
journal = "American Journal of Health-System Pharmacy",
issn = "1079-2082",
publisher = "American Society of Health-Systems Pharmacy",
number = "23",

}

TY - JOUR

T1 - Evaluation of Adherence to current guidelines for treatment of hyperlipidemia in adults in an outpatient setting

AU - Ng, Christina

AU - Chung, Philip

AU - Toderika, Yuliana

AU - Cheng-Lai, Angela

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Purpose: Adherence to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline at an outpatient clinic was evaluated. Methods: This retrospective chart review study was conducted from December 1, 2013, through November 30, 2014, at an urban outpatient clinic. Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was calculated based on the pooled cohort equation for all patients. Patients were categorized into one of four statin-benefit groups, in descending order of ASCVD risk. The recommended intensity of a statin and the therapeutic response were determined for each patient. If statin therapy was indicated, patients were assigned to the moderate-intensity, moderate- or high-intensity, or high-intensity group according to guideline recommendations. These guideline-recommended statin intensities were then compared to the patient's prescribed statin to determine guideline concordance. Therapeutic response, expressed as the percent decrease in low-density lipoprotein cholesterol, was determined based on recommended statin intensity. Results: A total of 255 patients were initiated on statin therapy; 193 were included for data analysis. Overall adherence to the guideline was 65.8%, with the highest rate in the group of patients with the lowest risk of ASCVD (97.8%). The group with the lowest rate of adherence to recommendations was patients with clinical ASCVD (46.9%). Only 31.6% of patients had a follow-up lipid panel performed, and even fewer achieved a therapeutic response. Conclusion: A majority of patients were initiated on the appropriate intensity of statin therapy according to the ACC/AHA cholesterol guideline. Of the small number of patients who had follow-up visits, few achieved a therapeutic response based on their prescribed statin therapy.

AB - Purpose: Adherence to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline at an outpatient clinic was evaluated. Methods: This retrospective chart review study was conducted from December 1, 2013, through November 30, 2014, at an urban outpatient clinic. Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was calculated based on the pooled cohort equation for all patients. Patients were categorized into one of four statin-benefit groups, in descending order of ASCVD risk. The recommended intensity of a statin and the therapeutic response were determined for each patient. If statin therapy was indicated, patients were assigned to the moderate-intensity, moderate- or high-intensity, or high-intensity group according to guideline recommendations. These guideline-recommended statin intensities were then compared to the patient's prescribed statin to determine guideline concordance. Therapeutic response, expressed as the percent decrease in low-density lipoprotein cholesterol, was determined based on recommended statin intensity. Results: A total of 255 patients were initiated on statin therapy; 193 were included for data analysis. Overall adherence to the guideline was 65.8%, with the highest rate in the group of patients with the lowest risk of ASCVD (97.8%). The group with the lowest rate of adherence to recommendations was patients with clinical ASCVD (46.9%). Only 31.6% of patients had a follow-up lipid panel performed, and even fewer achieved a therapeutic response. Conclusion: A majority of patients were initiated on the appropriate intensity of statin therapy according to the ACC/AHA cholesterol guideline. Of the small number of patients who had follow-up visits, few achieved a therapeutic response based on their prescribed statin therapy.

KW - 2013 cholesterol guideline

KW - ASCVD

KW - Atherosclerotic cardiovascular disease

KW - Guideline adherence

KW - Hyperlipidemia

KW - Statins

UR - http://www.scopus.com/inward/record.url?scp=85000473325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85000473325&partnerID=8YFLogxK

U2 - 10.2146/ajhp160050

DO - 10.2146/ajhp160050

M3 - Article

C2 - 27864236

AN - SCOPUS:85000473325

VL - 73

SP - S133-S140

JO - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 23

ER -