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. 2023 Jun 22:23:100534.
doi: 10.1016/j.lana.2023.100534. eCollection 2023 Jul.

Assessing statins use in a real-world primary care digital strategy: a cross-sectional analysis of a population-wide digital health approach

M Julia Machline-Carrion  1 , Alysson Nathan Girotto  1 , Josué Nieri  2 , Pedro Marton Pereira  1 , Frederico Monfardini  2 , Francisco Forestiero  3 , Priscila Raupp  3 , Fabiana Roveda  3 , Karla Santo  2 , Otávio Berwanger  2   4   5 , Raul D Santos  2   6
Affiliations

Assessing statins use in a real-world primary care digital strategy: a cross-sectional analysis of a population-wide digital health approach

M Julia Machline-Carrion et al. Lancet Reg Health Am. .

Abstract

Background: The digitization of the primary care system provides an opportunity to evaluate the current use of statins in secondary prevention populations (myocardial infarction or stroke).

Methods: We conducted a cross-sectional study (ClinicalTrials.gov, NCT05285085), analysing anonymised data routinely collected by community health workers (CHW) in Brazil between May 2016 and September 2021 to assess the proportion of self-reported statins use and associated factors.

Findings: From the 2,133,900 individuals on the database, 35,103 (1.6%), mean age 66.2 years (SD14.6), 49.5% (17,382/35,103) male sex, 50.5% (17,721/35,103) female sex, and 29.6% (10,381/34,975) Caucasians, had a previous myocardial infarction (MI) (n = 11,628; 33.1%) or stroke (n = 25,925; 73.9%). Approximately 50% (17,020/35,103) were from the Northeast region, 78.7% (27,605) from urban zones, and 39.4% (13,845) with social development index (SDI) >0.7. Overall, 6.7% (2346) and 0.6% (212) reported statins and high dose statins use, respectively. Age over 60 years old (OR 1.32 [95% CI 1.19-1.47), living in the Southern region (OR 4.53 [95% CI 3.66-5.60]), having a previous diagnosis of MI (OR 4.53 [95% CI 3.66-5.60]), heart failure (OR 2.29 [95% CI 1.13-1.47]), diabetes (OR 1.50 [95% CI 1.37-1.64]), dyslipidaemia (OR 2.90 [95% CI 2.55-3.29]), chronic kidney disease (OR 1.27 [95% CI 1.08-1.48]) and use of anti-hypertensives (OR 5.47 [95% CI 4.60-6.47]) were associated with statin use.

Interpretation: The analysis of a real-world database from a digitized primary care system, allowed us to identify a very low use of statins in secondary prevention Brazilian patients, mostly influenced by socio-demographic factors and co-morbidities.

Funding: Novartis Biociências, Brazil.

Keywords: Digital health; Dyslipidaemia; Primary care; Statins use.

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Conflict of interest statement

MJMC received research grants from Amgen, GSK, Ipsen and Novartis. FF has stock options from Novartis Biociências. PMP has received research grants from Ipsen and Takeda; honoraria for presentations from Swiss Basel Area; travel support from Astra Zeneca; PR has contracts and has received travel support from Novartis Biociências. OB received research grants from Astra Zeneca, Bayer, Servier and Amgen. RDS received research grants from Amgen, Sanofi, Novartis, Kowa and Esperion; consulting fees from Amgem, Astra, Zeneca, Abbot, Amryt, Pfizer, Hypera, Libbs, Novo-Nordisk, Novartis; honoraria for lectures, speakers bureaus, presentations from Abbott, Amgen, Astra Zeneca, Biolab, Libbs, Pfizer, Novo Nordisk, Eli-Lilly, Sanofi; has received travel support from Novo Nordisk and has played a leadership role in the International Atherosclerosis Society.

Figures

Fig. 1
Fig. 1
Lipid lowering agents and cardiovascular prevention drugs in secondary prevention individuals.
See this image and copyright information in PMC

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