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Article

Trends in high intensity statin use among secondary prevention patients 76 years and older

Michele Wood1★, Thomas Delate1, Sheila L. Stadler1, Anne M. Denham1, Leslie K. Ruppe1, Roseanne Hornak1, Kari L. Olson1★ Corresponding author

  1. 1Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, United States.

CORRESPONDENCE

Michele Wood

PharmD. Clinical Pharmacy Specialist. Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO, United States.

mdw71943@gmail.com

Received: 05-11-2018; Accepted: 11-04-2019.

Volume 17, Issue 2 · pp. 1–8 · PUBLISHED Apr-Jun 2019 · DOI: 10.18549/PharmPract.2019.2.1402

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ABSTRACT

Background: High intensity statin therapy (HIST) is the gold standard therapy for decreasing the risk of recurrent atherosclerotic cardiovascular disease (ASCVD); however, little is known about the use of HIST in older adults with ASCVD. Objectives: The aim of this cross-sequential study was to determine trends in statin intensity in older adults over a 10-year timeframe. Methods: The study was conducted in an integrated healthcare delivery system. Patients were 76 years or older with validated coronary ASCVD. Data were collected from administrative databases. Statin intensity level was assessed in eligible patients on January 1st and July 1st from January 1, 2007 to December 31, 2016. Results: Overall, a total of 5,453 patients were included with 2,119 (38.9%) and 3,334 (61.1%) categorized as HIST and Non-HIST, respectively. Included patients had a mean age of 79.8 years and were primarily male and white and had a cardiac intervention. The rate of HIST use increased from 14.5% to 41.3% over the study period (p<0.001 for trend). Conversely, the rates of moderate and low intensity statin use decreased from 61.8% and 9.8% to 41.2% and 4.8%, respectively (both p<0.001 for trend). Similar trends were identified for females and males. Conclusions: The percentage of patients with ASCVD 76 years and older who received HIST substantially increased from 2007 to 2016. This trend was identified in both females and males. Future comparative effectiveness research should be conducted in this patient population to examine cardiac-related outcomes with HIST and Non-HIST use.

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    Wood, M., Delate, T., Stadler, S. L., Denham, A. M., Ruppe, L. K., Hornak, R., & Olson, K. L. (2019). Trends in high intensity statin use among secondary prevention patients 76 years and older. Pharmacy Practice, 17(2), 1–8. https://doi.org/10.18549/PharmPract.2019.2.1402