Statin Initiation: Guideline Concordance and Characteristics of New Users in Quebec, Canada

Main Article Content

Sarasa M.A. Johnson https://orcid.org/0000-0002-8729-5926
Manon Choinière
Michèle Bally
Marie-Pierre Dubé
Jean-Claude Tardif
Daniel Gaudet
Jean Bergeron
Hélène Lanctôt
Jacques Lelorier

Keywords

guideline adherence, HMG-CoA reductase inhibitors, prospective cohort, statins

Abstract

Statins are widely prescribed for the prevention of cardiovascular (CV) events. Our objective was to describe the characteristics of patients newly prescribed a statin by general practitioners and assess the concordance of prescribing with national guidelines. Patients who were 18 years or older, French-speaking, available for the 2-year study duration, and had no history of statin use were recruited. Biological parameters were measured, and medical history, sociodemographic characteristics, and health behaviours were recorded using structured questionnaires. Patients’ eligibility for a statin was assessed using the Canadian Cardiovascular Society’s dyslipidemia guidelines. Of the 1631 new statin-users enrolled, 47.6% were women. The mean age for all patients was 57.4 years. According to the Canadian guidelines, 50.6% of patients were considered at high risk for a CV event or had a statin-indicated condition. Moderate and low-risk patients represented 26.7 and 22.7% of patients, respectively.
Abstract 71 | PDF Downloads 20 HTML Downloads 2 XML Downloads 0

References

1. Statistics Canada. Table 13-10-0394-01 leading causes of death, total population, by age group. http://dx.doi.org/10.25318/1310039401-eng. [Accessed on December 08, 2018].

2. Genest J, McPherson R, Frohlich J, Anderson T, Campbell N, Carpentier A, et al. 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult – 2009 recommendations. Can J Cardiol. 2009;25(10):567–79. http://www.ncbi.nlm.nih.gov/pubmed/19812802.

3. Anderson TJ, Grégoire J, Pearson GJ, Barry AR, Couture P, Dawes M, et al. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32(11):1263–82. http://dx.doi.org/10.1016/j. cjca.2016.07.510

4. Van Staa TP, Smeeth L, Ng ESW, Goldacre B, Gulliford M. The efficiency of cardiovascular risk assessment: Do the right patients get statin treatment? Heart. 2013;99(21):1597–602. http://dx.doi. org/10.1136/heartjnl-2013-303698

5. Wu J, Zhu S, Yao GL, Mohammed MA, Marshall T. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardio-vascular disease in UK general practice: A national retrospective cohort study. PLoS One. 2013;8(7):e67611. http://dx.doi.org/10.1371/journal. pone.0067611

6. Cascino T, Vali M, Redberg R, Bravata DM, Boscardin J, Eilkhani E, et al. Guideline concordance of new statin prescriptions: Who got a sta-tin? Am J Manag Care. 2017;23(9):528–33. http:// www.ncbi.nlm.nih.gov/pubmed/29087155

7. Hennessy DA, Bushnik T, Manuel DG, Anderson TJ. Comparing guidelines for statin treatment in Canada and the United States. J Am Heart Assoc. 2015;4(7):e001758. http://dx.doi. org/10.1161/JAHA.114.001758

8. Lopez-Carmona D, Bernal-Lopez MR, Mancera-Romero J, Jansen-Chaparro S, Portales-Fernandez I, Baca-Osorio AJ, et al. Compliance with cardiovascular drug prevention measures in a general population: The Multidisciplinary Intervention in Primary Care (IMAP) study. Eur J Prev Cardiol. 2012;19(5):1074–81. http://dx.doi. org/10.1177/1741826711418166

9. Bourgault C, Davignon J, Fodor G, Gangné C, Gaudet D, Genest J, et al. Statin therapy in Canadian patients with hypercholesterolemia: The Canadian Lipid Study – Observational (CALIPSO). Can J Cardiol. 2005;21:1187–93. http://www.ncbi.nlm. nih.gov/pubmed/16308595

10. Statistics Canada. Table 4 – Top five prescription medications used, by sex, age group and medication class, household population aged 25 to 79, Canada, 2007 to 2011. https://www150.statcan. gc.ca/n1/pub/82-003-x/2014006/article/14032/tbl/ tbl4-eng.htm [Access on January 19, 2020].

11. Brown F, Singer A, Katz A, Konrad G. Statin-prescribing trends for primary and secondary prevention of cardiovascular disease. Can Fam Physician. 2017;63(11):e495–503. http://www.ncbi. nlm.nih.gov/pubmed/29138175

12. Hennessy DA, Tanuseputro P, Tuna M, Bennet C, Perez R, Shields M, et al. Population health impact of statin treatment in Canada. Statistics Canada; 2016. Health Reports No. 82-003-X201600114305. ht t ps://w w w150.st atcan.gc.ca /n1/pub/82-003-x/2016001/article/14305-eng.htm

13. Gupta M, Singh N, Tsigoulis M, Kajil M, Hirjikaka S, Quan A, et al. Perceptions of Canadian primary care physicians towards cardio-vascular risk assessment and lipid management. Can J Cardiol. 2012;28(1):14–19. http://dx.doi. org/10.1016/j.cjca.2011.09.014

14. Mortensen MB, Nordestgaard BG. Comparison of five major guidelines for statin use in primary prevention in a contemporary general population. Ann Intern Med. 2018;168(2):85–92. http://dx.doi. org/10.7326/M17-0681

15. Gasevic D, Ross ES, Lear SA. Ethnic differences in cardiovascular disease risk factors: A systematic review of North American evidence. Can J Cardiol. 2015;31(9):1169–79. http://dx.doi. org/10.1016/j.cjca.2015.06.017

Most read articles by the same author(s)