Statin Prescribing in Diabetes Impacted by Patient Ethnicity, Physician Specialty
WASHINGTON, DC—Previous research has shown the benefits of statin therapy in patients with diabetes, a population that is particularly at risk for developing ischemic heart disease. However, not all patients may be receiving these drugs despite widely published guidelines.
"Unfortunately, racial and gender inequities in the provision of medical care remain a considerable problem," said Christopher Latanich, from Loyola University Medical Center, Maywood, IL, lead author of the study. "We specifically studied the provision of primary prevention statins to diabetic patients with particular attention to gender and ethnic differences."
The research, presented at the ACC.17 Scientific Session, examines the differences in statin prescribing among various physician specialties and the reasons behind them.
This one year retrospective study conducted in 2014, included 4334 patients with diabetes with no known ischemic heart disease. Patients were managed in the ambulatory setting at Loyola University Medical Center by either a primary care physician (PCP) or cardiologist.
Of these patients, 4195 were included in the final analyses; 70% of patients were prescribed a statin. Men and women received similarly intensive statins, however, significant differences were seen based on ethnicity; non-white patients received significantly less intensive statins (P<0.0001). In addition, compared to patients treated by a PCP, those treated by cardiologists received significantly more intensive treatment (P<0.0001) with a referral for an average 2.1 problems.
After factors such as age, gender, ethnicity, BMI, creatinine, HbA1c, and the physician specialty, the statin treatment intensity varied significantly based on patient age (P<0.0001), ethnicity (P<0.0001), HbA1c (P=0.0003), serum creatinine (P=0.0115) and physician specialty (P=0.0193). "Neither patient sex nor BMI, however, were predictive of treatment intensity," Latanich added.
"Among a large cohort of diabetic patients without coronary artery disease, we found significant differences in the intensity of statin treatment provided to patients based upon ethnicity, age, serum creatinine concentrations, HbA1c, and the specialty of the treating physician," the authors said. They concluded with a recommendation for more education to ensure prescribing practices are similar across all specialties.