Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD
- 25 August 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Cardiovascular Drugs and Therapy
- Vol. 34 (6), 745-754
- https://doi.org/10.1007/s10557-020-07057-y
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
Funding Information
- Health Services Research and Development (IIR 16–072)
- American Heart Association (14BGIA20460366)
- American Diabetes Association Clinical Science and Epidemiology (1-14- CE-44)
- Health Services Research and Development (CIN13-413)
This publication has 40 references indexed in Scilit:
- Meta-Analysis of Statin Effects in Women Versus MenJournal of the American College of Cardiology, 2012
- Frequency and correlates of treatment intensification for elevated cholesterol levels in patients with cardiovascular diseaseAmerican Heart Journal, 2011
- Secondary Prevention and Mortality in Peripheral Artery DiseaseCirculation, 2011
- Benefit of Intensive Statin Therapy in WomenCirculation: Cardiovascular Quality and Outcomes, 2011
- Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trialsThe Lancet, 2010
- Good and poor adherence: optimal cut-point for adherence measures using administrative claims dataCurrent Medical Research and Opinion, 2009
- Risk factor profiles and use of cardiovascular drug prevention in women and men with peripheral arterial diseaseEuropean Journal of Preventive Cardiology, 2009
- Suboptimal use of statin therapy in elderly patients with atherosclerosis: A population-based studyJournal of Vascular Surgery, 2008
- Meta‐analysis of large randomized controlled trials to evaluate the impact of statins on cardiovascular outcomesBritish Journal of Clinical Pharmacology, 2004
- Awareness, Perception, and Knowledge of Heart Disease Risk and Prevention Among Women in the United StatesArchives of Family Medicine, 2000