Assessing prescriptions for statins in ambulatory diabetic patients in the United States: a national, cross-sectional study.
BACKGROUND
Diabetes mellitus affects >20 million people in the United States each year, and >4000 new cases are diagnosed daily.


OBJECTIVE
This study assessed the prescription of statin medications in the ambulatory setting in US diabetic patients.


METHODS
We used data from the 2002 through 2004 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. All ambulatory medical visits associated with a diabetes diagnosis by the International Classification of Diseases, Ninth Revision, Clinical Modification were included. Prescriptions for statin medications were determined by searching each ambulatory visit for relevant drug names (trade and generic). Demographic characteristics were assessed, including survey year, sex, age group, race, ethnicity, payment type, region of the country, and physician's specialty and degree. Analyses used sample weights to calculate national estimates.


RESULTS
From 2002 to 2004, 10,046 (unweighted) ambulatory visits were made by diabetic patients, representing a weighted national estimate of approximately 153 million visits. A statin prescription was associated with 21.1% of all diabetic visits and 14.1% of those without a hyperlipidemia-related diagnosis. Diabetic men were more likely than diabetic women to be given a prescription for a statin (odds ratio [OR], 1.38; 95% CI, 1.09-1.73). Compared with diabetic patients treated in 2002, those treated in 2003 and 2004 were more likely to be prescribed statin therapy (2003 OR, 1.51; 95% CI, 1.02-2.24; 2004 OR, 1.48; 95% CI, 1.03-2.15). Compared with diabetic patients aged 45 to 64 years, those in younger age groups were less likely to be given a statin prescription (1-24 years OR, 0.10; 95% CI, 0.01-0.84; 25-44 years OR, 0.48; 95% CI, 0.31-0.74), and those aged 65 to 74 years were more likely to be given a statin (OR, 1.38; 95% CI, 1.01-1.90). No differences were noted for diabetic patients aged > or = 75 years.


CONCLUSIONS
From 2002 through 2004, <25% of the ambulatory medical visits by diabetic patients in the United States were associated with a statin prescription. Male sex and age up to 75 years had an increased association with statin prescription. Additional study is anticipated to assess changes in statin use in diabetic patients in the United States as updated treatment guidelines are released.
Segars
Larry W
LW
Department of Pharmacology, Kansas City University of Medicine and Biosciences, Kansas City, Missouri 64106, USA. lsegars@kcumb.edu
Lea
Amanda R
AR
D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000208:ethnology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D016568:Drugs, Generic / Q000627:therapeutic use; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D016017:Odds Ratio; D010045:Outpatients / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D016568:Drugs, Generic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors