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.

Full Abstract

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.

DESIGN:
Retrospective chart review.

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

PATIENTS:
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).

MAIN OUTCOME MEASURES:
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.

CONCLUSION:
This study demonstrates suboptimal treatment with statins in patients with type 2 diabetes and cardiovascular risk factors.

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Author information

Author/s: Rosenberg, Jack M (JM); Zerilli, Tina (T); Nathan, Joseph P (JP); McGuire, Howard (H);

Affiliation: International Drug Information Center, Long Island University, Brooklyn, New York 11201, USA. J666666(-atsign-)attglobal.Net

Journal and publication information

Publication Type: Journal Article

Journal: The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists (Consult Pharm), published in United States. (Language: eng)

Reference: 2007-Jan; vol 22 (issue 1) : pp 38-44

Dates: Created 2007/03/19; Completed 2007/04/10;

PMID: 17367251, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Ambulatory Care
Antilipemic Agents - administration & dosage; therapeutic use
Day Care
Diabetes Complications - prevention & control
Diabetes Mellitus, Type 2 - complications; drug therapy
Female
Gemfibrozil - therapeutic use
Humans

Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; therapeutic use
Male
Pharmaceutical Services
Pharmacists
Retrospective Studies
Risk Factors
Vascular Diseases - etiology; prevention & control

Associated Chemicals: Antilipemic Agents (0) ; Hydroxymethylglutaryl-CoA Reductase Inhibitors (0) ; Gemfibrozil (25812-30-0)

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