LONG-TERM STATIN PERSISTENCE IS POOR AMONG HIGH-RISK PATIENTS WITH BASELINE PERIPHERAL ARTERY DISEASE: A REAL-WORLD ADMINISTRATIVE CLAIMS ANALYSIS OF THE OPTUM RESEARCH DATABASE

Abstract Background A decade ago, statin persistence was < 50% after 1 year, and recent short-term analyses have revealed very little progress in improving statin persistence, even in patients with a prior cardiovascular (CV) event. Data on longer-term statin persistence are lacking. We measured long-term statin persistence in patients with high CV risk. Methods This retrospective administrative claims analysis of the Optum Research Database included patients aged ≥ 45 years with diabetes and/or atherosclerotic CV disease (ASCVD) who had a statin prescription filled in 2010. It included an elevated triglycerides (TG) cohort of patients with index date in 2010 and TG ≥ 150 mg/dL (n = 23,181) and a propensity-matched comparator cohort with TG < 150 mg/dL and high-density lipoprotein cholesterol > 40 mg/dL (n = 23,181). Both cohorts were followed for ≥ 6 months up to March 2016. Results The probability of remaining on a prescription fill for index statin therapy was 47% after 1 year and 19% after 5 years in both cohorts. Statin persistence was worse among women than men, and among younger versus older patients (P < 0.001 for all comparisons). After 5 years, the probability of remaining on a prescription fill for index statin was < 25% across all subgroups assessed including patients with and without baseline revascularization, heart failure, peripheral artery disease and renal disease. Similar results were observed in a subcohort analysis of patients with TG 200–499 mg/dL. Conclusions Long-term statin persistence after 5 years is alarmingly low (< 25%) and is a public health concern.

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TCT-530 Long-term Cost Patterns of Directional Atherectomy vs. Other Treatment Choices for Diabetes Patients with Peripheral Artery Disease: a 12-Month Analysis of Administrative Claims Data

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.08.1276 ◽

2013 ◽

Vol 62 (18) ◽

pp. B160

Author(s):

Khusrow Niazi ◽

Michael Grabner ◽

Katrine L. Wallace

Keyword(s):

Peripheral Artery Disease ◽

Claims Data ◽

Administrative Claims ◽

Peripheral Artery ◽

Treatment Choices ◽

Administrative Claims Data ◽

Directional Atherectomy ◽

Artery Disease ◽

Diabetes Patients

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Abstract 266: Are Outpatient Cardiologists Asking about Peripheral Artery Disease Clinical Symptoms in Low and High Risk Patients in accordance with ACC/AHA Guidelines?

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.5.suppl_1.a266 ◽

2012 ◽

Vol 5 (suppl_1) ◽

Author(s):

Ankitkumar K Patel ◽

Rajesh M Kabadi ◽

Rajani Sharma ◽

Rita Schmidt ◽

Elias Iliadis

Keyword(s):

Risk Factors ◽

At Risk ◽

High Risk ◽

Peripheral Artery Disease ◽

Clinical Symptoms ◽

Low Risk ◽

Peripheral Artery ◽

Symptom Screening ◽

Risk Patients ◽

Artery Disease

Background: Lower extremity peripheral artery disease (PAD) is a common syndrome that afflicts many individuals and leads to significant morbidity. The American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Peripheral Artery Disease (PAD) (JACC, 2006) outlines four clinical symptoms (claudication, walking impairment, exertional leg complaints and poorly healing wounds) that should be asked to at risk patients. Outpatient cardiology practices often take care of individuals at risk for PAD and have the opportunity to screen and improve quality of medical care in accordance with professional guidelines. Methods: A group of 367 outpatients seen in a large academic cardiology practice from September 2011 underwent chart review. Risk factors for PAD that were assessed include history of smoking, hypertension, diabetes, hyperlipidemia, homocysteine levels, and CRP. Those that had three or more risk factors or a previous diagnosis of known PAD were classified as high risk and those with less than 2 risk factors were classified as low risk. Documentation of whether clinical symptoms were asked was obtained from outpatient chart. Fisher exact test was utilized for statistical analysis. Results: Fifty-seven percent (N=208) of our population were classified as high risk for PAD and forty-three percent (N=158) were low risk. Table 1 below shows assessment of clinical symptoms in high and low risk patients. Conclusions: Though both high risk and low risk PAD patients are assessed at equivalent rates for clinical symptoms, the vast majority of patients overall are underassessed. Lack of knowledge of clinical symptoms can lead to underscreening of PAD and thus undertreatment. Increasing clinical symptom screening in the outpatient cardiology setting can lead to quality improvement and adherence to ACC/AHA Guidelines.

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