Use of statins and gemfibrozil in patients with type 2 diabetes mellitus and cardiovascular risk factors attending adult day health care centers: an opportunity for pharmacists.
OBJECTIVE
Identify the extent of statin use for primary prevention of macrovascular complications, the extent of statin or gemfibrozil use for the secondary prevention of cardiovascular morbidity and mortality, and the statin doses used in patients with type 2 diabetes and other cardiovascular risk factors.


METHODS
Retrospective chart review.


METHODS
Three adult day health care centers in Brooklyn and Queens, New York.


METHODS
Patients with a diagnosis of type 2 diabetes and either a history of coronary artery disease or at least one other significant cardiovascular risk factor as defined by the American College of Physicians guidelines (i.e., age greater than 55 years, hypertension, left-ventricular hypertrophy, previous cerebrovascular disease, or peripheral arterial disease).


METHODS
Percentage of patients prescribed a statin for primary prevention of macrovascular complications of type 2 diabetes, percentage of patients prescribed a statin or gemfibrozil for secondary prevention of cardiovascular mortality and morbidity, and the percentage of patients on at least moderate doses of statins.


RESULTS
Ninety-three patients were evaluated-51 in the primary-prevention group and 42 in the secondary-prevention group. In the primary-prevention group, 33 (64.7%) patients were prescribed a statin, while in the secondary-prevention group, 26 (61.9%) patients were on statins, a nonsignificant difference (P = 0.8308). No patients were prescribed gemfibrozil. Of all patients prescribed statins, 63.2% were at least on moderate doses.


CONCLUSIONS
This study demonstrates suboptimal treatment with statins in patients with type 2 diabetes and cardiovascular risk factors.
Rosenberg
Jack M
JM
International Drug Information Center, Long Island University, Brooklyn, New York 11201, USA. J666666@attglobal.Net
Zerilli
Tina
T
Nathan
Joseph P
JP
McGuire
Howard
H
D000553:Ambulatory Care; D003631:Day Care, Medical; D048909:Diabetes Complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D015248:Gemfibrozil / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010593:Pharmaceutical Services; D010595:Pharmacists; D012189:Retrospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology / Q000517:prevention & control*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D015248:Gemfibrozil