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Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system.

Publication ,  Journal Article
Ahmed, ST; Mahtta, D; Rehman, H; Akeroyd, J; Al Rifai, M; Rodriguez, F; Jneid, H; Nasir, K; Samad, Z; Alam, M; Petersen, LA; Virani, SS
Published in: Am Heart J
March 2020

BACKGROUND: Statin use remains suboptimal in patients with atherosclerotic cardiovascular disease (ASCVD). We assessed if the frequency of visits with primary care providers (PCPs) is associated with higher use of evidence-based statin prescriptions and adherence among patients with ASCVD. METHODS: We identified patients with ASCVD aged ≥18 years receiving care in 130 facilities and associated community-based outpatient clinics in the entire Veterans Affairs Health Care System between October 1, 2013 and September 30, 2014. Patients were divided into frequent PCP visitors (annual PCP visits ≥ median number of PCP visits for the entire cohort) and infrequent PCP visitors (annual PCP visits < median number of patient visits). We assessed any- and high-intensity statin prescription as well as statin adherence which was defined by proportion of days covered (PDC). RESULTS: We included 1,249,061 patients with ASCVD (mean age was 71.9 years; 98.0% male). Median number of annual PCP visits was 3. Approximately 80.1% patients were on statins with 23.8% on high-intensity statins. Mean PDC was 0.715 ± 0.336 with 58.3% patients with PDC ≥0.8. Frequent PCP visitors had higher frequency of statin use (82.2% vs 77.4%), high-intensity statin use (26.4% vs 20.3%), and statin adherence (mean PDC 0.73 vs 0.68; P < .01) compared to infrequent PCP visitors. After adjusting for covariates, frequent PCP visits was associated with greater odds of being on any statin, high intensity statin, and higher statin adherence. CONCLUSION: Frequent visits with PCPs is associated with a higher likelihood of any statin use, high intensity statin use, and statin adherence. Further research endeavors are needed to understand the reasons behind these associations.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2020

Volume

221

Start / End Page

9 / 18

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Primary Health Care
  • Practice Patterns, Physicians'
  • Physicians, Primary Care
  • Middle Aged
  • Medication Adherence
  • Male
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
 

Citation

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ICMJE
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Ahmed, S. T., Mahtta, D., Rehman, H., Akeroyd, J., Al Rifai, M., Rodriguez, F., … Virani, S. S. (2020). Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system. Am Heart J, 221, 9–18. https://doi.org/10.1016/j.ahj.2019.11.019
Ahmed, Sarah T., Dhruv Mahtta, Hasan Rehman, Julia Akeroyd, Mahmoud Al Rifai, Fatima Rodriguez, Hani Jneid, et al. “Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system.Am Heart J 221 (March 2020): 9–18. https://doi.org/10.1016/j.ahj.2019.11.019.
Ahmed, Sarah T., et al. “Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system.Am Heart J, vol. 221, Mar. 2020, pp. 9–18. Pubmed, doi:10.1016/j.ahj.2019.11.019.
Ahmed ST, Mahtta D, Rehman H, Akeroyd J, Al Rifai M, Rodriguez F, Jneid H, Nasir K, Samad Z, Alam M, Petersen LA, Virani SS. Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system. Am Heart J. 2020 Mar;221:9–18.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2020

Volume

221

Start / End Page

9 / 18

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Primary Health Care
  • Practice Patterns, Physicians'
  • Physicians, Primary Care
  • Middle Aged
  • Medication Adherence
  • Male
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans