Statin Use and Its Facility‐Level Variation in Patients With Diabetes: Insight From the Veterans Affairs National Database

We examined frequency and facility‐level variation in use of any or at least moderate‐intensity statin therapy (mean daily dose associated with ≥30% low‐density lipoprotein cholesterol lowering). In 911 444 patients with DM, 68.3% and 58.4% were receiving any and moderate‐ to high‐intensity statin therapy, respectively. Patients receiving statin had higher burden of cardiovascular disease, were more likely to be on nonstatin lipid‐lowering therapy and to receive care at a teaching facility, and had more frequent primary‐care visits. Median facility‐level uses of any and at least moderate‐intensity statin therapy were 68.7% (interquartile range, 65.9%–70.8%) and 58.6% (interquartile range, 55.8%–61.4%), respectively. After adjusting for several patient‐related and some facility‐related characteristics, the median rate ratios for any and moderate‐ to high‐intensity statin therapy were 1.20 (95% confidence interval: 1.18‐1.22) and 1.29 (95% confidence interval: 1.24‐1.33) respectively, indicating 20% to 29% variation in statin use between 2 identical patients receiving care at 2 random facilities. Statin use was suboptimal in a national sample of patients with DM with modest facility‐level variation, likely indicating differences in statin‐prescribing patterns.
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Quality and Outcomes Source Type: research