4th Annual WML Academic Symposium

In 2008, the American Diabetes Association (ADA) recommended all diabetics >40 years with cardiovascular disease (CVD) or >1 CVD risk factor(s) be prescribed a statin. This study assessed statin use in the National Hospital Ambulatory Medical Care Survey-Outpatient Department (NHAMCS-OPD) and National Ambulatory Medical Care Survey (NAMCS) for 2005-2007 and 2008-2010 for adherence to ADA guidelines. A retrospective, cross-sectional, observational design included diabetics >18 years in NHAMCS-OPD or NAMCS between 2005-2010 without statin contraindications. The study was IRB-exempt as it used only publicly available, de-identified data from the Centers for Disease Control and Prevention. Chi-square tests were conducted to analyze the proportion of statins (p<0.05 significant). A multivariate logistic regression model included all variables with an overall chi-square test p-value <0.2. Odds ratios (OR) and 95% confidence intervals (CI) were reported. No association between statin use and year (2008-2010 vs. 2005-2007) was identified (OR 1.17, 95% CI 0.97-1.40). The following groups were significantly less likely to receive a statin: 18-39 years (vs. 40-64 years, OR 0.51, 95% CI 0.36 – 0.73) and Hispanics (vs. non-Hispanics, OR 0.79, 95% CI 0.62-0.99). Patients with the following diagnoses were significantly more likely to receive a statin: hyperlipidemia (vs. no hyperlipidemia, OR 4.17, 95% CI 3.46-5.03) and hypertension (vs. no hypertension, OR 1.26, 95% CI 1.08-1.48). Statin receipt is not increasing and only a small percentage of patients receive a statin as recommended (29.3%). Adjusting for covariates, ethnicity, age, hypertension and hyperlipidemia were significant predictors of a statin. This study highlights the need to determine the underlying reasons for low statin prescribing, and to identify the determinants relating to treatment disparity in certain groups of diabetic patients.