Abstract Details

Title Rate of provider utilization of lipid lowering medication or lifestyle intervention counseling in ASCVD patients: An NHANES population analysis

Topic General Neurology

Presentation(s) Neuroepidemiology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 017

Background Several studies have shown that lipid lowering medications and lifestyle interventions can reduce MACE in patients with ASCVD. Low patient adherence to the AHA recommend statin therapy has been reported. However, low utilization of these medications or lifestyle counseling by providers has not been well studied.

Objective

To study the frequency at which atherosclerotic cardiovascular disease (ASCVD) patient are advised by their provider to take prescription cholesterol lowering medication or make lifestyle modifications to lower their risk of major adverse cardiovascular events (MACE).

Design/Methods

NHANES is a dataset of select participants who are representative of the civilian, noninstitutionalized US population. We queried four NHANES datasets: 2011-2012, 2013-1014 and 2015-2016 and identified participants who answered “yes” to: 1. Ever told you had coronary heart disease, 2. Ever told you had heart attack, 3. Ever told you had angina/angina pectoris and 4. Ever told you had a stroke. Among these ASCVD patients we identified patients who reported that they were advised to take cholesterol lowering medications, counseled regarding exercise, weight loss and diet and if these patients were compliant with these recommendations.

Results Overall, 1617 ASCVD patients were identified. Data on cholesterol medications was missing in 137 patients. Among the remaining 1480 only 1050 (71%) reported being asked by their provider to take cholesterol lowering medication. Out of those 1050, only 914 were compliant with the medication. Lifestyle modification counseling was provided in approximately one-half of the patients (47% told to reduce fat or calories, 54% told to increase exercise, 39% told to control or lose weight). LDL levels were available in 690 of 1617 participants. LDL >100 was reported in 533 (77%) of those 690 ASCVD participants.

Conclusions There is suboptimal provider prescription of cholesterol lowering medication and lifestyle interventions in ASCVD patients. Increase in utilization of these strategies could lead to lowering of MACE.

Authors/Disclosures
Ravi Pande, MD PRESENTER	Dr. Pande has nothing to disclose.
	No disclosure on file
Scott L. Silliman, MD (U.F. College of Medicine-Jacksonville)	Dr. Silliman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech.