National Trends in Statin Medication Prescribing in Patients With a History of Stroke or Transient Ischemic Attack

National Trends in Statin Medication Prescribing in Patients With a History of Stroke or Transient Ischemic Attack

Snyder Brittany M; Soric Mate M

Journal of Pharmacy Practice

2019

2019-07

BACKGROUND: Guidelines support statin therapy post-stroke or transient ischemic attack (TIA); however, previously reported utilization rates are suboptimal. OBJECTIVE: This study investigates the incidence of statin usage in patients with a documented stroke or TIA while identifying predictors of statin use. METHODS: A retrospective, cross-sectional study utilizing data from the National Ambulatory Medical Care Survey. RESULTS: A total of 2963 unweighted visits were included in the analysis, representing a total of 52 645 000 office visits when weighted. Statin therapy was initiated or continued in 35.7% (95% confidence interval [CI]: 32.4-39.0%) of office visits. Upon multivariate analysis, positive predictors of statin therapy included a diagnosis of hyperlipidemia (odds ratio [OR]: 3.60; 95% CI: 2.40-5.41), angiotensin-converting enzyme inhibitor (ACE-I) therapy (OR: 2.52; 95% CI: 1.69-3.76), aspirin therapy (OR: 2.02; 95% CI: 1.40-2.93), and clopidogrel therapy (OR: 2.60; 95% CI: 1.69-4.02). Negative predictors of statin therapy included office visits with neurologists when compared to visits with primary care practitioners (OR: 0.55; 95% CI: 0.33-0.90) and office visits in rural areas when compared to office visits in urban areas (OR: 0.64; 95% CI: 0.41-0.99). CONCLUSION: Various factors impact statin therapy use with overall utilization being suboptimal, highlighting an opportunity for medication optimization.

statin; stroke; transient ischemic attack

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