OBJECTIVES:

Dyslipidemia is a major contributor to the evolution of cardiovascular disease (CVD) among patients with type 2 diabetes mellitus (T2DM). There is a guideline recommendation to offer statin therapy to all T2DM patients between 40 to 75 years old for either primary or secondary CVD prophylaxis. Nevertheless, the suboptimal management of diabetic dyslipidemia in the Malaysian primary care settings has been reported. This study aimed to describe the statin therapy prescribing pattern among patients with T2DM, evaluate the appropriateness of statin therapy prescribing, and assess the level of achievement of the primary target (LDL-C) for diabetic dyslipidemia treatment.

METHODS:

A cross-sectional study involved 404 T2DM patients from four primary health clinics in the state of Pahang, Malaysia. The patients were considered for the study if they met the age requirements (between 40 to75 years), and had no clinical contraindications to receive statin therapy. The Diabetes Registry and patients’ medical records were reviewed to assess the pattern of statin therapy prescribing from January 2015 till December 2016.

RESULTS:

The overall percentage of T2DM patients receiving statin therapy was 83.6% (338/404). Approximately 16.4% of study cases were not receiving any lipid-lowering therapy. The most common pattern change noted in lipid-lowering therapy prescribing was the switching between different types of statin treatment (24%). Statin therapy was appropriately prescribed in 67% of the cases. About 16% of the lipid-lowering therapy prescriptions have at least one significant drug interaction with co-prescribed medications. Finally, the lipid-lowering therapy prescribing achieved the primary target of LDL-C levels in only 40% of T2DM patients.

CONCLUSIONS:

Lipid-lowering therapy prescribing in the primary care settings needs to be further improved to cover all eligible patients, and to decrease the incidence of drug-drug interactions. Additional statin therapy intensification or use of combination therapy may be needed to enhance the achievement of LDL-C targets among patients with T2DM.