Association of patient, provider and facility related characteristics with statin associated side effects and statin use: Insight from the Veteran's Affairs healthcare system

Xiaoming Jia, Michelle T. Lee, David J. Ramsey, Dhruv Mahtta, Julia M. Akeroyd, Alexander Turchin, Ann Marie Navar, Michael E. Matheny, Glenn Gobbel, Neil J. Stone, Vijay Nambi, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Statin associated side effects (SASE) are a leading cause of statin discontinuation. Objective: We evaluated patient, provider, and facility characteristics associated with SASEs and whether these characteristics impact statin utilization. Methods: Patients with atherosclerotic cardiovascular disease (ASCVD) receiving care across the Veterans Affairs healthcare system from October 1, 2014 to September 30, 2015 were included. Multivariable logistic regression analyses were performed to determine (a) factors associated with SASE and (b) factors associated with statin use in those with SASE. Results: Our cohort included 1,225,576 patients with ASCVD. Of these, 171,189 (13.7%) had at least 1 reported SASE since year 2000. The most significant odds for SASEs were observed with female sex (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.36, 1.45), White race (OR 1.43, 95% CI 1.41, 1.45), hypertension (OR 1.37, 95% CI 1.33, 1.41) and ischemic heart disease (IHD: OR 1.45, 95% CI 1.43, 1.47). Lower odds were noted with care at a teaching facility (OR 0.89, 95% CI 0.88, 0.90). Factors most associated with being on a statin among patients with SASE included having diabetes (OR 1.18, 95% CI 1.15, 1.20), IHD (OR 1.39, 95% CI 1.35, 1.43) and a higher number of cardiology visits (OR 1.08, 95% CI 1.07, 1.09), while female sex was associated with lower odds (OR 0.65, 95% CI 0.61, 0.69). Conclusion: There are significant disparities in statin use by sex, ASCVD type, and comorbidities among secondary prevention patients with SASE, which represent areas for improvement in optimizing statin utilization.

Original languageEnglish (US)
Pages (from-to)832-839
Number of pages8
JournalJournal of Clinical Lipidology
Volume15
Issue number6
DOIs
StatePublished - Nov 1 2021

Keywords

  • Statin utilization
  • Statin-associated muscle symptoms
  • Statin-associated side effects

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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