Winchester, VA—Clinical guidelines are very clear on the necessity of statins in patients with diabetes, with the American Diabetes Association’s Standards of Medical Care in Diabetes—2017 calling the drugs the “first-line lipid lowering medication.”

A study in Diabetes Spectrum sought to compare statin prescribing practices according to those standards of medical care between diabetes patients managed by pharmacists versus those managed by internal medicine providers.

Researchers at the Bernard J. Dunn School of Pharmacy at Shenandoah University completed a retrospective observational study using the electronic health record of a multispecialty private practice. The study included 176 patients, with 88 each in the pharmacy and internal medicine groups.

Participants were aged 40 years or older with a diabetes diagnosis and managed by an internal medicine provider or a pharmacist between January and December 2017.

Results indicate that more pharmacy than internal medicine patients were prescribed appropriate statin therapy (47.7 vs. 34.1%, P = .092), especially those needing high-intensity statins (44.3 vs. 27.4%, P = .03).

More likely to receive appropriate treatment in the pharmacy group were females, patients aged 40 to 75 years, and patients with no history of atherosclerotic cardiovascular disease (37.5 vs. 15.0%, P = .022; 46.8 vs. 29.7%, P = .039; and 45.3 vs. 23.5%, P = .015, respectively).

In the overall study, however, more males than females were prescribed appropriate statin therapy (53.1 vs. 26.3%, P = 0.001), the authors note.

“Although there were no overall significant differences in statin prescribing between the pharmacy and internal medicine groups, patients needing high-intensity statins, those who were female, and those who were younger were more likely to receive appropriate therapy when managed by a pharmacist,” the authors conclude. “Appropriate statin prescribing remains low among diabetes patients, and optimization of this therapy should be prioritized.”

The guidelines state, “High-dose statin therapy is recommended for all patients with diabetes with a history of clinical atherosclerotic CVD or with at least one additional CVD risk factor. Moderate-dose statin therapy is also suggested for patients younger than 40 or older than 70 who have CVD risk factors.”

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