Lipid testing among patients beginning statin therapy in general practice in the United Kingdom.
OBJECTIVE
To determine the frequency of lipid testing and to identify the factors predictive of lipid-testing frequency over a 1-year period in patients beginning statin treatment.


METHODS
Retrospective cohort study performed using the UK General Practice Research Database. The patients were selected if they were > or = 35 years of age, received first-ever statin between January 2000 and December 2004, had at least one total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), or triglyceride (TG) test conducted in the 1-year period before statin initiation, and had at least 1 year of follow-up data. The main outcome measures were TC, HDL-C, and TG testing frequencies in the year after initiating statins. Poisson regression was used to assess baseline factors associated with testing frequency for each lipid.


RESULTS
In the year after initiating statins, the patients received a mean (+/-SD) of 1.3 (+/-1.0) TC tests, 0.9 (+/-1.0) HDL-C tests, and 0.9 (+/-1.0) TG tests; however, 22.7%, 44.3%, and 39.1% of the patients did not receive any TC, HDL-C, and TG tests, respectively. In multivariate analyses, a high coronary heart disease (CHD) risk (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.07) and elevated baseline TC (> or = 6.2 vs. < 5.0 mmol/L; OR 1.12; 95% CI 1.06-1.18) were significantly associated with greater TC testing frequency.


CONCLUSIONS
High risk of CHD and elevated baseline TC were associated with greater rates of TC testing in the year after statin initiation. Lack of TC testing in approximately one in five patients, and infrequent HDL-C and TG testing may be barriers to comprehensive lipid management.
Phatak
Hemant
H
Merck & Co., Inc., Whitehouse Station, NJ 08889, USA. hemant_phatak@merck.com
Wentworth
Chuck
C
Burke
Thomas A
TA
D000368:Aged; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000188:drug therapy*; D019992:Databases as Topic; D005194:Family Practice; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016012:Poisson Distribution; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D006113:United Kingdom
D008076:Cholesterol, HDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol