Analysis and comparison of statin prescription patterns and outcomes according to clinical department

Abstract

What is known and objectiveThere is a disparity between the Korean treatment guidelines and actual clinical prescription habits. This study was designed to evaluate the department-specific disparities and achievement rates for low-density lipoprotein cholesterol (LDL-C) targets, based on each department's specific statin prescription patterns. MethodsWe retrospectively evaluated data from 31718 patients who had been prescribed a statin at least once between January 2008 and June 2013 at our institution. Patients were classified into the high-risk (target LDL-C<100mg/dL) or moderate-risk (target LDL-C<130mg/dL) groups, according to the National Cholesterol Education Programme-Adult Treatment PanelIII guidelines. Results and discussionStatins were most commonly prescribed in the cardiology (320%) and endocrinology (266%) departments. For the high-risk group, 70% of patients in the cardiology, endocrinology and cardiac surgery departments achieved their target LDL-C levels (<100mg/dL). However, the target achievement rates in most other departments were <70%. For the moderate-risk group, 792% of patients achieved their target levels. Departments that prescribed a greater number of high- or intermediate-potency statins were more likely to achieve their target LDL-C levels. The group that achieved their target LDL-C levels (<100mg/dL) exhibited a significant positive relationship (Spearman's correlation coefficient=08571, P=00065), from low to high potency. What is new and conclusionSome departments tend to undertreat when prescribing statins. However, to reach to the target LDL-C levels, physicians must overcome their tendency to undertreat with statins. We believe that the target achievement rate will increase if doctors are more actively aware of a patient's individual status and related risk factors before prescribing statins.