PRIMARY PREVENTION OF HYPERLIPIDEMIA- TREATMENT AND COMPLIANCE IN REAL WORLD PRACTICE
Author(s)
Avgil Tsadok M, Feldman B, Bachrach A, Balicer RD
Clalit Research Institute, Tel Aviv, Israel
Presentation Documents
OBJECTIVES: Hyperlipidemia is a major cause of disease burden globally due to its role in cardiovascular disease (CVD). Primary prevention and treatment of hyperlipidemia has been a major focus in public health over the last decade. We aimed to describe a cohort of individuals with hyperlipidemia taking pharmacological treatments for primary prevention, their adherence to treatment, and the proportion achieving target lipids levels. METHODS: We built a population-based cohort of Clalit members with hyperlipidemia (without indications for CVD) first diagnosed between 2012 and 2013, using integrated electronic medical record data. We present the annual number of individuals who purchased lipid lowering medications in 2014 and 2015. Adherence was assessed using the proportion of days covered (PDC), and proportion of individuals meeting lipid target goals were evaluated one year after treatment. RESULTS: During 2014 and 2015, among 61,650 individuals who were newly identified with hyperlipidemia, 26% purchased lipid lowering medications. Members who purchased lipid lowering agents had a higher risk for CVD compared for those who did not purchase (mean Framingham 10-year score 13.9% vs. 8.9%). HMG-CoA reductase inhibitors were the main pharmaceuticals purchased and only one-third adhered to this treatment regimen during the year following initiation. One year after treatment initiation, only half of the treated population achieved LDL-C, non-HDL-C, and total cholesterol targets (47.7%, 48.9% and 44.1%, respectively). CONCLUSIONS: Based on real-world data, we found that a low proportion of individuals with hyperlipidemia without indication for CVD consume lipid-lowering therapy. Furthermore, adherence to treatment is low and only half of those on medication achieve the recommended lipid target levels within a year. There is much that can be improved in clinical decision-making to achieve lipid targets in the majority of at-risk patients, including using the right medication at an appropriate dosage and focusing efforts in improving adherence to treatment.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCV137
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Health Care Research, Prescribing Behavior, Quality of Care Measurement, Treatment Patterns and Guidelines
Disease
Cardiovascular Disorders