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Geographic Variation in Statin Use for Complex Acute Myocardial Infarction Patients

Evidence of Effective Care

Bibliographic Data

ID9101953
AuthorsJohn M Brooks (0000-0001-7365-4417, University of Iowa, corresponding author), Edwin A Cook (0000-0002-7608-8702), Elizabeth A Cook (0000-0002-3496-9587, corresponding author), Cole G Chapman (0000-0002-1132-3767, corresponding author), Puttarin Kulchaitanaroaj (0000-0002-8710-9863, corresponding author), Elizabeth A Chrischilles (0000-0002-1843-1955, University of Iowa), Stephen Welch (0000-0002-9060-0223, corresponding author), Jennifer Robinson (0000-0002-7716-4770), Jennifer G Robinson (0000-0002-4432-4352, University of Iowa)
Year2014
Volume52
IssueSupplement 2
PagesS37-S44
Publication date2014-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3182a7fc3d
PMID24561757
OpenAlexW2023603030
LanguageEN
Citations received3
References cited17

BACKGROUND: Despite strong evidence to designate statin use for secondary prevention of cardiovascular disease (CVD) as "effective care," observational studies show that many patients with CVD do not receive statins. This suggests that statin prescribing decisions for complex CVD patients are preference sensitive. OBJECTIVES: The aim of this study was to evaluate local area variation in statin prescribing for subsets of complex patients after acute myocardial infarction (AMI) to assess whether current statin prescribing patterns fit profiles of either "effective care" or "preference-sensitive care." RESEARCH DESIGN AND SUBJECTS: This was a retrospective cohort study of 124,618 Medicare patients with fee-for-service parts A, B, and D benefits who were hospitalized with AMI in 2008 or 2009 with no evidence of AMI in the past 12 months. MEASURES: Patient complexity was defined by the presence of diabetes, heart failure, and chronic kidney disease in the year before AMI admission. Local area practice styles for "no statin," "lower-intensity statins," and "high-intensity statins" were measured using the driving area for clinical care method. Statin prescribing rates for complex patient subsets were contrasted across patients grouped by local areas practice styles. RESULTS: Lower statin treatment rates were observed for patients with complex conditions, especially among those with heart failure. However, substantial local area variation in statin prescribing is observed across all complex patient groups. CONCLUSIONS: Despite guidelines promoting the use of statins for secondary prevention for CVD patients, substantial local area variation suggests that patient and provider beliefs and preferences weigh heavily in statin prescribing decisions

Cohort · Cohort study · Diabetes mellitus · Disease · Heart failure · Intensive care medicine · Myocardial infarction · Observational study · Physical therapy · Retrospective cohort study · Statin · Emergency Medicine · Internal Medicine · Lipoproteins and Cardiovascular Health · Medication Adherence and Compliance · Medicine · Pharmaceutical Practices and Patient Outcomes

  • Geographic Variation of Statin Use Among US Nursing Home Residents With Life-limiting Illness

    Deborah S Mack, Jonggyu Baek et al.•Medical Care•2021

  • Statin Use After Acute Myocardial Infarction by Patient Complexity

    John M Brooks, Elizabeth Cook et al.•Medical Care•2015

  • Use of Statins by Medicare Beneficiaries Post Myocardial Infarction

    Open Access•Mary C Schroeder, Jennifer G Robinson et al.•INQUIRY The Journal of Health…•2015

  • A New Method to Isolate Local-Area Practice Styles in Prescription Use as the Basis for Instrumental Variables in Comparative Effectiveness Research

    Gang Fang, John M Brooks et al.•Medical Care•2010

Unique citing works3
Citations per year0,27
Citation span2015 - 2021 (7)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1

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