A036 Prescription and Early Dispensing of Statin Therapy Following Acute Coronary Syndrome in Non surgically Revascularised Patients- Nationwide Perspective

Abstract

Early initiation and long-term adherence to statin therapy improves outcomes in patients following acute coronary syndrome (ACS). Previous New Zealand national analysis showed only two thirds of these patients were maintained on long-term statin therapy. It is unclear if suboptimal prescription and/or initial dispensation is a causative factor. Cohort (N=16557) was identified from All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry data for consecutive New Zealand residents (1 January 2015 to 31 December 2017) who underwent coronary angiogram without surgical revascularisation following ACS. These were linked to national data sets through encrypted patient identifiers to derive medication data. We looked at statin prescription at discharge, early dispensing (3 months) and calculated medication possession ratio (MPR) at one year. 15431 (93%) patients in the cohort were prescribed statin therapy at discharge with similar early dispensing rate. There is high rate of initial prescription and dispensing across various demographics with high rate for male sex and Indian ethnicity. Adequate statin maintenance (MPR ≥ 0.8) at one year is suboptimal (n=13219, 80%) particularly in the younger patients, female sex, Māori/Pacific ethnicity, and lower income population. Higher initial prescribing and early dispensing rates across various demographics suggests minimal barriers to early statin use post myocardial infarction. However, statin maintenance at one year remains suboptimal which suggests a more robust follow up or outpatient strategy is required.