title: Evaluation of adherence to current guidelines for treatment of hyperlipidemia in adults in an outpatient setting.
abstract: OBJECTIVE
  Adherence to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline at an outpatient clinic was evaluated.
  
  
  METHODS
  This retrospective chart review study was conducted from December 1, 2013, through November 30, 2014, at an urban outpatient clinic. Estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was calculated based on the pooled cohort equation for all patients. Patients were categorized into one of four statin-benefit groups, in descending order of ASCVD risk. The recommended intensity of a statin and the therapeutic response were determined for each patient. If statin therapy was indicated, patients were assigned to the moderate-intensity, moderate- or high-intensity, or high-intensity group according to guideline recommendations. These guideline-recommended statin intensities were then compared to the patient's prescribed statin to determine guideline concordance. Therapeutic response, expressed as the percent decrease in low-density lipoprotein cholesterol, was determined based on recommended statin intensity.
  
  
  RESULTS
  A total of 255 patients were initiated on statin therapy; 193 were included for data analysis. Overall adherence to the guideline was 65.8%, with the highest rate in the group of patients with the lowest risk of ASCVD (97.8%). The group with the lowest rate of adherence to recommendations was patients with clinical ASCVD (46.9%). Only 31.6% of patients had a follow-up lipid panel performed, and even fewer achieved a therapeutic response.
  
  
  CONCLUSIONS
  A majority of patients were initiated on the appropriate intensity of statin therapy according to the ACC/AHA cholesterol guideline. Of the small number of patients who had follow-up visits, few achieved a therapeutic response based on their prescribed statin therapy.
authors.affiliation: Montefiore Medical Center, Bronx, NY. chng@montefiore.org.
authors.forename: Christina
authors.initials: C
authors.lastname: Ng
authors.affiliation: Montefiore Medical Center, Bronx, NY.
authors.forename: Philip
authors.initials: P
authors.lastname: Chung
authors.affiliation: Long Island University Pharmacy, Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY.|Montefiore Medical Center, Bronx, NY.
authors.forename: Yuliana
authors.initials: Y
authors.lastname: Toderika
authors.affiliation: Montefiore Medical Center, Bronx, NY.
authors.forename: Angela
authors.initials: A
authors.lastname: Cheng-Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods / Q000592:standards*; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D012189:Retrospective Studies
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: 2013 cholesterol guideline; ASCVD; atherosclerotic cardiovascular disease; guideline adherence; hyperlipidemia; statins