Optimization of the Statin Therapy Algorithm in Outpatient Practice: Adherence and Economic Benefits
Open Access
- 3 March 2021
- journal article
- research article
- Published by Silicea - Poligraf in Rational Pharmacotherapy in Cardiology
- Vol. 17 (1), 49-55
- https://doi.org/10.20996/1819-6446-2020-11-10
Abstract
The high prevalence of lipid metabolism disorders in the Russian population and their contribution to cardiovascular risk require an optimization of their pharmacotherapy in clinical practice. Aim. To study adherence to recommended treatment, additional clinical and economic benefits of a titration-free statin therapy regimen. Material and methods. Ambulatory patients (n=300) with a high or very high risk of hypercholesterolemia who have indications for statin treatment for primary or secondary prevention of cardiovascular diseases is included in a non-randomized trial. Patients are divided into 2 groups. Group 1 had a titration regimen of statins in accordance with current recommendations (group 1A [n=50] – primary cardiovascular prevention; group 1B [n=100] – secondary cardiovascular prevention). Group 2 received a titration-free statin regimen in fixed doses (group 2A [n=50] – primary cardiovascular prevention; group 2B [n=100] – secondary cardiovascular prevention). Patients were prescribed atorvastatin (10-80 mg/day) or rosuvastatin (10- 40 mg/day). Group 1 patients had visits to the doctor after 1, 3, 6 and 12 months from the start of statin use, group 2 patients after 3 and 12 months. Treatment adherence, effects on surrogate and hard endpoints, and cost-effectiveness of the two statin regimens were evaluated. Results. The target level of low-density lipoprotein cholesterol (LDL-C) after 12 months in group 2 was achieved in 56.4% of patients versus 53.4% in group 1. The average level of LDL-C decreased by 1.84±0.44 mmol / l in group 2 versus a decrease of 1.61±0.47 mmol / L in group 1. The costeffectiveness ratio was 9658.72 rubles in group 2 versus 8341.73 rubles in group 1 for a 1 mmol / l LDL-C level decrease in 1 patient within a year. An increase in annual costs per patient in group 2 compared with group 1 by 75.76 rubles reduced the relative risk of developing a combined endpoint by 1% per year. Conclusion. The use of a titration-free statin treatment regimen allowed us not only to more effectively control of LDL-c levels in patients with high and very high cardiovascular risk compared to the traditional statin therapy regimen, but also to obtain economic advantages in patients with high and very high cardiovascular risk.Keywords
This publication has 15 references indexed in Scilit:
- Studying the Possibility of Optimizing the Statin Therapy Algorithm in Outpatient PracticeRational Pharmacotherapy in Cardiology, 2020
- Burden of Coronary Artery Disease and Peripheral Artery Disease: A Literature ReviewCardiovascular Therapeutics, 2019
- Features and main problems of treating patients with high and very high cardiovascular risk with statins in real clinical practice (according to the data of the “PRIORITET” research)Cardiovascular Therapy and Prevention, 2018
- 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive SummaryJournal of the American College of Cardiology, 2018
- Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017The Lancet, 2018
- Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017The Lancet, 2018
- 2016 ESC/EAS Guidelines for the Management of DyslipidaemiasAtherosclerosis, 2016
- LIPID-LOWERING THERAPY IN OUTPATIENT PRACTICE (ACCORDING TO THE ARGO-2 STUDY)Rational Pharmacotherapy in Cardiology, 2016
- ANALYSIS OF HYPERCHOLESTEROLEMIA PREVALENCE IN THE OUTPATIENT PRACTICE (ACCORDING TO THE ARGO STUDY): PART IRational Pharmacotherapy in Cardiology, 2015
- DIAGNOSIS AND TREATMENT OF PATIENTS WITH SEVERE HYPERCHOLESTEROLEMIA IN REAL OUTPATIENT PRACTICE (ACCORDING TO THE RECVASA REGISTRY)Rational Pharmacotherapy in Cardiology, 2014