Retrospective Comparison of Appropriate Statin Use Between Patients With Diabetes in the Primary Care Setting Managed by Pharmacists or Internal Medicine Providers.

Abstract

The purpose of this study was to compare statin prescribing practices according to the American Diabetes Association's Standards of Medical Care in Diabetes-2017 between diabetes patients managed by pharmacists versus those managed by internal medicine providers. A retrospective observational study was completed using the electronic health record of a multispecialty private practice. A total of 176 patients were included in the study, with 88 each in the pharmacy and internal medicine groups. Patients were ≥40 years of age with diabetes and managed by an internal medicine provider or a pharmacist between January and December 2017. Descriptive statistics, χ2, and unpaired t tests were used to describe between-group differences. More pharmacy than internal medicine patients were prescribed appropriate statin therapy (47.7 vs. 34.1%, P = 0.092), particularly those needing high-intensity statins (44.3 vs. 27.4%, P = 0.03). Females, patients 40-75 years of age, and patients with no history of atherosclerotic cardiovascular disease in the pharmacy group were more likely to receive appropriate treatment (37.5 vs. 15.0%, P = 0.022; 46.8 vs. 29.7%, P = 0.039; and 45.3 vs. 23.5%, P = 0.015, respectively). Overall, more males than females were prescribed appropriate statin therapy (53.1 vs. 26.3%, P = 0.001). 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. Appropriate statin prescribing remains low among diabetes patients, and optimization of this therapy should be prioritized.