Research Update and Precision Dosing Survey Opportunity 1. NCAP is interested in the ongoing Comprehensive Medication Management (CMM) project being led by investigators at UNC and funded by ACCP. For the March 2017 quarterly update, go to: https://www.accp. com/report/index.aspx?iss=0317&art=1 2. The UNC Eshelman School of Pharmacy is undertaking a Precision Dosing Initiative. One of the first steps is to determine what, if any, information is available concerning integration of precision dosing software into the electronic medical record and how that is being used by providers. We have prepared a brief survey on this topic. The survey should take no more than 10 minutes to complete. The survey has been reviewed by the UNC Biomedical IRB, and it was determined that the survey did not constitute Human Subjects Research. Here is the link to the survey: https://unc.az1.qualtrics.com SE/?SID=SV_9tMm4AphJGglsKp
Prescribing Patterns of Statin Therapy Compared to American Diabetes Association Standards of Care at an Academic Internal Medicine Center Adam Corey, Jennifer J. Kim Abstract Objective: This study aims to describe the adherence to guidelines published by the American Diabetes Association with regard to statin therapy in lipid-lowering treatment. Per 2016 recommendations, all patients with diabetes mellitus between the ages of 40 and 75 should be on statin therapy, if tolerated. This guideline includes patients with atherosclerotic cardiovascular comorbidities and at least one risk factor who are candidates for therapy with a high-intensity statin. 32
Methods: This retrospective, descriptive study analyzed all patients age 40-75 years and diagnosed with diabetes mellitus with a documented clinic encounter between January 1, 2015 through August 15, 2016. Patients were excluded if they did not have a documented primary care physician at the time of data collection. Data collected included current medications, medical conditions, height, weight, LDL, and history of statin use. Results: Six hundred twenty-nine patients were included in the study. The majority of patients (450, 71.5%) were currently on statin therapy. Of the 179 patients (28.5%) not receiving a statin, only 12 (5.2%) had a non-statin lipid-lowering agent on profile. In addition, 65 patients (36.3%) had no stated history of statin use, 28 patients (15.6%) reported intolerance to statin, and 72 patients (40.2%) lost statin therapy after prior use. Conclusion: Based on the available data, guidelinedirected treatment is being followed in the setting of medical resident training with multiple opportunities for pharmacist-led interventions to improve statin prescribing for diabetes patients.
Introduction Heart disease remains the leading cause of death in the United States.1 For atherosclerotic cardiovascular disease (ASCVD) risk reduction, the American Diabetes Association (ADA) standards of care recommends that, with lifestyle changes, diabetes patients between the ages 40 and 75 years should be considered for statin therapy of at least moderate-intensity. High-intensity statin therapy is recommended for those with a history of prior ASCVD events (coronary artery disease, cerebrovascular accident, or peripheral artery disease) or the presence of one of more risk factors including an LDL-cholesterol ≥ 100 mg/dL, hypertension, smoking, body-mass index (BMI) ≥ 25, or family history of premature ASCVD.2 Disease-state guidelines assist clinical practitioners in determining treatment, generally based on available clinical evidence. Adherence to ADA guidelines is expected to improve clinical outcomes for diabetes patients by managing the disease and reducing morbidity and mortality. The reduction of ASCVD events and mortality favors the use of statin therapy in diabetes patients, improving patient outcomes and reducing costs. Initiation of statins depends on the prescriber to educate the patient and recommend use. The patient’s use of statins depends
