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LONG-TERM STATIN USE FOLLOWING RE-INITIATION AMONG MEDICARE BENEFICIARIES WITH CORONARY HEART DISEASE
1848 JACC April 5, 2016 Volume 67, Issue 13
Prevention LONG-TERM STATIN USE FOLLOWING RE-INITIATION AMONG MEDICARE BENEFICIARIES WITH CORONARY HEART DISEASE Moderated Poster Contributions Prevention Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-9:55 a.m. Session Title: Registries and Big Data: Informing Practices in CVD Prevention Abstract Category: 33. Prevention: Clinical Presentation Number: 1202M-01 Authors: John N. Booth, Lisandro Colantonio, Robert Rosenson, Monika Safford, Ligong Chen, Meredith Kilgore, Todd Brown, Emily Levitan, Benjamin Taylor, Ricardo Dent, Keri Monda, Paul Muntner, University of Alabama at Birmingham, Birmingham, AL, USA, Amgen, Inc., Thousand Oaks, CA, USA Background: The benefits of statin use after a myocardial infarction (MI) hospitalization accrue over time. Discontinuing statins in the year following initiation is common. We determined the percentage of Medicare beneficiaries who re-initiate statins and had high statin persistence following re-initiation. Factors associated with high statin persistence were also identified.
Methods: We studied all beneficiaries with full fee-for-service coverage who discontinued statins after a MI hospitalization in 2007-2010. Beneficiaries with no statin fills in the 365 days prior to hospitalization and with a fill in the 30 days post-discharge (n=131,596) were followed for 182 days post-discharge to identify statin discontinuation, defined as 60 continuous days without statins. Statin re-initiation was detected in the 365 days post-discontinuation. High statin persistence, the proportion of days covered ≥ 80%, was assessed in the 182 days after re-initiation. Results: Of the 21,817 (16.6%) beneficiaries who discontinued statins, 12,049 (55.2%) re-initiated and of these 5,693 (47.3%) had high persistence. After multivariable adjustment, older age, low income, diabetes, stroke, chronic kidney disease, incident heart failure and cardiologist care after a MI were associated with statin persistence (Table).
Conclusions: Less than 50% of Medicare beneficiaries had high persistence following statin re-initiation. Post-discharge cardiologist care may be important for increasing statin persistence.
Prevention LONG-TERM STATIN USE FOLLOWING RE-INITIATION AMONG MEDICARE BENEFICIARIES WITH CORONARY HEART DISEASE Moderated Poster Contributions Prevention Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-9:55 a.m. Session Title: Registries and Big Data: Informing Practices in CVD Prevention Abstract Category: 33. Prevention: Clinical Presentation Number: 1202M-01 Authors: John N. Booth, Lisandro Colantonio, Robert Rosenson, Monika Safford, Ligong Chen, Meredith Kilgore, Todd Brown, Emily Levitan, Benjamin Taylor, Ricardo Dent, Keri Monda, Paul Muntner, University of Alabama at Birmingham, Birmingham, AL, USA, Amgen, Inc., Thousand Oaks, CA, USA Background: The benefits of statin use after a myocardial infarction (MI) hospitalization accrue over time. Discontinuing statins in the year following initiation is common. We determined the percentage of Medicare beneficiaries who re-initiate statins and had high statin persistence following re-initiation. Factors associated with high statin persistence were also identified.
Methods: We studied all beneficiaries with full fee-for-service coverage who discontinued statins after a MI hospitalization in 2007-2010. Beneficiaries with no statin fills in the 365 days prior to hospitalization and with a fill in the 30 days post-discharge (n=131,596) were followed for 182 days post-discharge to identify statin discontinuation, defined as 60 continuous days without statins. Statin re-initiation was detected in the 365 days post-discontinuation. High statin persistence, the proportion of days covered ≥ 80%, was assessed in the 182 days after re-initiation. Results: Of the 21,817 (16.6%) beneficiaries who discontinued statins, 12,049 (55.2%) re-initiated and of these 5,693 (47.3%) had high persistence. After multivariable adjustment, older age, low income, diabetes, stroke, chronic kidney disease, incident heart failure and cardiologist care after a MI were associated with statin persistence (Table).
Conclusions: Less than 50% of Medicare beneficiaries had high persistence following statin re-initiation. Post-discharge cardiologist care may be important for increasing statin persistence.