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 language | English (US) |
|---|---|
| Pages (from-to) | S133-S140 |
| Journal | American Journal of Health-System Pharmacy |
| Volume | 73 |
| Issue number | 23 |
| DOIs | |
| State | Published - Dec 1 2016 |
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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 journal › Article
}
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 -