Abstract 16990: Impact of 2013 ACC/AHA Cholesterol Management Guidelines on Statins Use Among Nationally Representative Adult Populations in United States: Medical Expenditure Panel Survey (2010-2015)

Abstract

Background: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Management Guidelines recommended statin as the first-line lipid-lowering therapy (LLT) for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). We aim to examine the impact of the guidelineson statin use in the US. Methods: Using the2010-2015 Medical Expenditure Panel Survey (MEPS) data, we estimated trends in statin utilization in adults age 40-75 years in 4 defined groups: (1) All adults, adults with: (2) established ASCVD, (3) diabetes mellitus [DM] and no ASCVD and, (4) estimated 10-year risk >=7.5% in absence of ASCVD and DM. Joint-point regression (JPR) analysis was used to examine changes in statin use trend around the period of the guideline’s publication. Results: We found no statistically significant change in statin use. (Figure) The use of any statin therapy in 2010-2012 ranged from 24.6 to 25.1%, and 24.6 to 25.1% in 2014-2015 among all adults. Statin use among those with ASCVD ranged from 58.8 to 56.6% (2010-2012) and 56.7-57.8% (2014-2015). Similar trends were noted in our two other study groups. However, a significantly higher proportion of statin users among established ASCVD patients reported use of high intensity doses: 34.3 to 38.1% post- versus 29.6 to 31.6% pre-guideline publication with an average annual percentage change (AAPC) of 4.9 (95% CI: 2.9-6.9). (Figure) Joint point regression showed no statistically significant inflection in the trend line of all and high-intensity statin use in any of the study groups after guideline publication. Conclusion: There was a mild increase in high-intensity statin use after the 2013 ACC/AHA guidelines release, but no impact on overall statin use in US two years after publication. Barriers to guideline adoption and opportunities to increase the impact of guidelines on clinical practice need to be investigated.