Pharmacist-Led Programs to Increase Statin Prescribing: A Narrative Review of the Literature.

Mary Elkomos,Michael S Kelly,Raha Jahromi

doi:10.3390/pharmacy10010013

Abstract

Statins are lipid-lowing medications shown to reduce cardiovascular events and are recommended for specific patient populations at elevated risk of atherosclerotic cardiovascular disease (ASCVD). Despite the demonstrated efficacy of statins for reducing ASCVD risk, and guidance on which populations should receive statin therapy, a substantial portion of eligible patients are not prescribed statin therapy. Pharmacists have attempted to increase the number of eligible patients receiving appropriate statin therapy through a variety of interventions and across several clinical settings. In this article, we highlight multiple studies evaluating the effectiveness of pharmacist-led interventions to improve statin use. A total of seven studies were selected for this narrative review, demonstrating the effectiveness and barriers of different statin-initiation programs delivered by pharmacists to increase statin use in eligible patients. Among the interventions assessed, a combination of provider communicating and statin prescribing through collaborative drug therapy management (CDTM) appear to the be the most useful at increasing statin use. Pharmacists can significantly improve statin use rates among eligible patients through multiple intervention types and across different clinical settings. Further studies should evaluate continued statin adherence and clinical outcomes among patients served by pharmacists.

Highlights

IntroductionCardiovascular disease (CVD) remains the leading cause of death in the world [1]
This study shows that a somewhat straightforward pharmacist intervention of messaging providers led to greater statin initiation and dispensed prescription rates among patients with diabetes mellitus (DM)
Multiple pharmacist-led interventions have led to increased statin use and are likely to improve statin-related outcome metrics; a substantial number of patients do not receive guideline recommended statin therapy

Summary

Introduction

Cardiovascular disease (CVD) remains the leading cause of death in the world [1]. In the United States, deaths due to CVD increased by nearly 5% from 2019 to 2020 [2]. The top two contributors to CVD mortality are coronary heart disease and stroke [1]. Prevalence of CVD increases with age, affects a greater proportion of men than women, and is more common in certain race/ethnicity groups such as non-Hispanic black patients [1]. Interventions to reduce the risk of CVD are multifactorial and include non-pharmacologic lifestyle changes and medications to treat modifiable major cardiovascular risk factors such as tobacco use, hypertension, diabetes mellitus (DM), and dyslipidemia [3,4]

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