Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD

Dhruv Mahtta; Sarah T. Ahmed; David J. Ramsey; Julia M. Akeroyd; Michelle T. Lee; Fatima Rodriguez; Erin D. Michos; Dipti Itchhaporia; Khurram Nasir; Mahboob Alam; Hani Jneid; Christie M. Ballantyne; Laura A. Petersen; Salim S. Virani

doi:10.1007/s10557-020-07057-y

Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD

Dhruv Mahtta, Sarah T. Ahmed, David J. Ramsey, Julia M. Akeroyd, Michelle T. Lee, Fatima Rodriguez, Erin D. Michos, Dipti Itchhaporia, Khurram Nasir, Mahboob Alam, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

Purpose: This study sought to investigate gender-based disparities in statin prescription rates and adherence among patients with peripheral arterial disease (PAD) and ischemic cerebrovascular disease (ICVD). Methods: We identified patients with PAD or ICVD seeking primary care between 2013 and 2014 in the VA healthcare system. We assessed any statin use, high-intensity statin (HIS) use, and statin adherence among women with PAD or ICVD compared with men. We also compared proportion of days covered (PDC) as a measure of statin adherence; PDC ≥ 0.8 deemed a patient statin adherent. Association between statin use (or adherence) and odds of death or myocardial infarction (MI) at 12-month follow-up was also ascertained. Results: Our analyses included 192,219 males and 3188 females with PAD and 331,352 males and 10,490 females with ICVD. Women with PAD had lower prescription rates of any statin (68.5% vs. 78.7%, OR 0.68, 95% confidence interval (CI) 0.62–0.75), HIS (21.1% vs. 23.7%, OR 0.88, 95% CI 0.79–0.97), and lower statin adherence (PDC ≥ 0.8: 34.6% vs. 45.5%, OR 0.75, 95% CI 0.69–0.82) compared with men. Similar disparities were seen in ICVD patients. Among female patients with PAD or ICVD, statin adherence was associated with lower odds of MI (OR 0.76, 95% CI 0.59–0.98), while use of any statin (OR 0.71, 95% CI 0.56–0.91) and HIS (OR 0.68, 95% CI 0.48–0.97) was associated with lower odds of death at 12 months. Conclusions: Women with PAD or ICVD had lower odds of receiving any statins, HIS, or being statin adherent. Targeted clinician- and patient-level interventions are needed to study and address these disparities among patients with PAD and ICVD.

Original language	English
Pages (from-to)	745-754
Number of pages	10
Journal	Cardiovascular Drugs and Therapy
Volume	34
Issue number	6
DOIs	https://doi.org/10.1007/s10557-020-07057-y
Publication status	Published - Dec 2020
Externally published	Yes

Keywords

Adherence
Gender disparities
ICVD
PAD
Prescription rates
Statin

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10557-020-07057-y

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Mahtta, D., Ahmed, S. T., Ramsey, D. J., Akeroyd, J. M., Lee, M. T., Rodriguez, F., Michos, E. D., Itchhaporia, D., Nasir, K., Alam, M., Jneid, H., Ballantyne, C. M., Petersen, L. A., & Virani, S. S. (2020). Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD. Cardiovascular Drugs and Therapy, 34(6), 745-754. https://doi.org/10.1007/s10557-020-07057-y

@article{f04b7a81d1a241d9ac2951ed74503fa5,

title = "Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD",

abstract = "Purpose: This study sought to investigate gender-based disparities in statin prescription rates and adherence among patients with peripheral arterial disease (PAD) and ischemic cerebrovascular disease (ICVD). Methods: We identified patients with PAD or ICVD seeking primary care between 2013 and 2014 in the VA healthcare system. We assessed any statin use, high-intensity statin (HIS) use, and statin adherence among women with PAD or ICVD compared with men. We also compared proportion of days covered (PDC) as a measure of statin adherence; PDC ≥ 0.8 deemed a patient statin adherent. Association between statin use (or adherence) and odds of death or myocardial infarction (MI) at 12-month follow-up was also ascertained. Results: Our analyses included 192,219 males and 3188 females with PAD and 331,352 males and 10,490 females with ICVD. Women with PAD had lower prescription rates of any statin (68.5% vs. 78.7%, OR 0.68, 95% confidence interval (CI) 0.62–0.75), HIS (21.1% vs. 23.7%, OR 0.88, 95% CI 0.79–0.97), and lower statin adherence (PDC ≥ 0.8: 34.6% vs. 45.5%, OR 0.75, 95% CI 0.69–0.82) compared with men. Similar disparities were seen in ICVD patients. Among female patients with PAD or ICVD, statin adherence was associated with lower odds of MI (OR 0.76, 95% CI 0.59–0.98), while use of any statin (OR 0.71, 95% CI 0.56–0.91) and HIS (OR 0.68, 95% CI 0.48–0.97) was associated with lower odds of death at 12 months. Conclusions: Women with PAD or ICVD had lower odds of receiving any statins, HIS, or being statin adherent. Targeted clinician- and patient-level interventions are needed to study and address these disparities among patients with PAD and ICVD.",

keywords = "Adherence, Gender disparities, ICVD, PAD, Prescription rates, Statin",

author = "Dhruv Mahtta and Ahmed, {Sarah T.} and Ramsey, {David J.} and Akeroyd, {Julia M.} and Lee, {Michelle T.} and Fatima Rodriguez and Michos, {Erin D.} and Dipti Itchhaporia and Khurram Nasir and Mahboob Alam and Hani Jneid and Ballantyne, {Christie M.} and Petersen, {Laura A.} and Virani, {Salim S.}",

note = "Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2020",

month = dec,

doi = "10.1007/s10557-020-07057-y",

language = "English",

volume = "34",

pages = "745--754",

journal = "Cardiovascular Drugs and Therapy",

issn = "0920-3206",

publisher = "Kluwer Academic Publishers",

number = "6",

}

Mahtta, D, Ahmed, ST, Ramsey, DJ, Akeroyd, JM, Lee, MT, Rodriguez, F, Michos, ED, Itchhaporia, D, Nasir, K, Alam, M, Jneid, H, Ballantyne, CM, Petersen, LA & Virani, SS 2020, 'Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD', Cardiovascular Drugs and Therapy, vol. 34, no. 6, pp. 745-754. https://doi.org/10.1007/s10557-020-07057-y

TY - JOUR

T1 - Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD

AU - Mahtta, Dhruv

AU - Ahmed, Sarah T.

AU - Ramsey, David J.

AU - Akeroyd, Julia M.

AU - Lee, Michelle T.

AU - Rodriguez, Fatima

AU - Michos, Erin D.

AU - Itchhaporia, Dipti

AU - Nasir, Khurram

AU - Alam, Mahboob

AU - Jneid, Hani

AU - Ballantyne, Christie M.

AU - Petersen, Laura A.

AU - Virani, Salim S.

PY - 2020/12

Y1 - 2020/12

N2 - Purpose: This study sought to investigate gender-based disparities in statin prescription rates and adherence among patients with peripheral arterial disease (PAD) and ischemic cerebrovascular disease (ICVD). Methods: We identified patients with PAD or ICVD seeking primary care between 2013 and 2014 in the VA healthcare system. We assessed any statin use, high-intensity statin (HIS) use, and statin adherence among women with PAD or ICVD compared with men. We also compared proportion of days covered (PDC) as a measure of statin adherence; PDC ≥ 0.8 deemed a patient statin adherent. Association between statin use (or adherence) and odds of death or myocardial infarction (MI) at 12-month follow-up was also ascertained. Results: Our analyses included 192,219 males and 3188 females with PAD and 331,352 males and 10,490 females with ICVD. Women with PAD had lower prescription rates of any statin (68.5% vs. 78.7%, OR 0.68, 95% confidence interval (CI) 0.62–0.75), HIS (21.1% vs. 23.7%, OR 0.88, 95% CI 0.79–0.97), and lower statin adherence (PDC ≥ 0.8: 34.6% vs. 45.5%, OR 0.75, 95% CI 0.69–0.82) compared with men. Similar disparities were seen in ICVD patients. Among female patients with PAD or ICVD, statin adherence was associated with lower odds of MI (OR 0.76, 95% CI 0.59–0.98), while use of any statin (OR 0.71, 95% CI 0.56–0.91) and HIS (OR 0.68, 95% CI 0.48–0.97) was associated with lower odds of death at 12 months. Conclusions: Women with PAD or ICVD had lower odds of receiving any statins, HIS, or being statin adherent. Targeted clinician- and patient-level interventions are needed to study and address these disparities among patients with PAD and ICVD.

AB - Purpose: This study sought to investigate gender-based disparities in statin prescription rates and adherence among patients with peripheral arterial disease (PAD) and ischemic cerebrovascular disease (ICVD). Methods: We identified patients with PAD or ICVD seeking primary care between 2013 and 2014 in the VA healthcare system. We assessed any statin use, high-intensity statin (HIS) use, and statin adherence among women with PAD or ICVD compared with men. We also compared proportion of days covered (PDC) as a measure of statin adherence; PDC ≥ 0.8 deemed a patient statin adherent. Association between statin use (or adherence) and odds of death or myocardial infarction (MI) at 12-month follow-up was also ascertained. Results: Our analyses included 192,219 males and 3188 females with PAD and 331,352 males and 10,490 females with ICVD. Women with PAD had lower prescription rates of any statin (68.5% vs. 78.7%, OR 0.68, 95% confidence interval (CI) 0.62–0.75), HIS (21.1% vs. 23.7%, OR 0.88, 95% CI 0.79–0.97), and lower statin adherence (PDC ≥ 0.8: 34.6% vs. 45.5%, OR 0.75, 95% CI 0.69–0.82) compared with men. Similar disparities were seen in ICVD patients. Among female patients with PAD or ICVD, statin adherence was associated with lower odds of MI (OR 0.76, 95% CI 0.59–0.98), while use of any statin (OR 0.71, 95% CI 0.56–0.91) and HIS (OR 0.68, 95% CI 0.48–0.97) was associated with lower odds of death at 12 months. Conclusions: Women with PAD or ICVD had lower odds of receiving any statins, HIS, or being statin adherent. Targeted clinician- and patient-level interventions are needed to study and address these disparities among patients with PAD and ICVD.

KW - Adherence

KW - Gender disparities

KW - ICVD

KW - PAD

KW - Prescription rates

KW - Statin

UR - http://www.scopus.com/inward/record.url?scp=85089823887&partnerID=8YFLogxK

U2 - 10.1007/s10557-020-07057-y

DO - 10.1007/s10557-020-07057-y

M3 - Article

C2 - 32840709

AN - SCOPUS:85089823887

SN - 0920-3206

VL - 34

SP - 745

EP - 754

JO - Cardiovascular Drugs and Therapy

JF - Cardiovascular Drugs and Therapy

IS - 6

ER -

Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD

Abstract

Keywords

UN SDGs

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