Changes in Statin Use Among U.S. Adults With Diabetes: A Population-Based Analysis of NHANES 2011–2018

Leino, Abbie D.; Dorsch, Michael P.; Lester, Corey A.

doi:10.2337/dc20-1481

Cited by 18 publications

(12 citation statements)

References 15 publications

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“…In NHANES, the percentage of adults 40 to 75 years of age with diabetes who were taking a statin was 48.5% in 2011 through 2014 and 53% in 2015 through 2018 ( P =0.133). 94…”

Section: Awareness Treatment and Controlmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2022

Circulation

3,064

2,336

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Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). Methods: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year’s worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. Results: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. Conclusions: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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“…In NHANES, the percentage of adults 40 to 75 years of age with diabetes who were taking a statin was 48.5% in 2011 through 2014 and 53% in 2015 through 2018 ( P =0.133). 94…”

Section: Awareness Treatment and Controlmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2022

Circulation

3,064

2,336

View full text Add to dashboard Cite

show abstract

“…Despite decades of evidence from multiple randomized controlled trials supporting the safety and effectiveness of statins to reduce ASCVD event risk, statin use for guideline-indicated primary prevention remains low, between 40 and 70% depending on clinical indication [2] , [3] , [4] , [5] . Analysis of US adults ≥ 40 years with diabetes from 2015 to 2018 found only 53% to be on statin therapy, despite over 90% having a usual source of healthcare [6] . Between 2013 and 2016, only 58.5% of participants in the American College of Cardiology National Cardiovascular Data Registry–Practice Innovation and Clinical Excellence registry who had an LDL-C ≥ 190 mg/dL were on a statin [7] .…”

Section: Introductionmentioning

confidence: 99%

Clinical encounter length and initiation of statin therapy for primary prevention among adults with elevated atherosclerotic cardiovascular disease risk

Zheutlin

Zhang

Conroy

2023

American Journal of Preventive Cardiology

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“…In 2015 to 2018, approximately half of a nationally representative cohort of individuals with diabetes in the United States were not on statins. 9 Statin nonuse is more common in underrepresented populations including women and minority groups, can contribute to excess cardiovascular events, and represents an important public health gap for cardiovascular disease prevention. 10 , 11 , 12 , 13 , 14 , 15 …”

mentioning

confidence: 99%

Identifying Reasons for Statin Nonuse in Patients With Diabetes Using Deep Learning of Electronic Health Records

Sarraju

Zammit

Ngo

et al. 2023

JAHA

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Background Statins are guideline‐recommended medications that reduce cardiovascular events in patients with diabetes. Yet, statin use is concerningly low in this high‐risk population. Identifying reasons for statin nonuse, which are typically described in unstructured electronic health record data, can inform targeted system interventions to improve statin use. We aimed to leverage a deep learning approach to identify reasons for statin nonuse in patients with diabetes. Methods and Results Adults with diabetes and no statin prescriptions were identified from a multiethnic, multisite Northern California electronic health record cohort from 2014 to 2020. We used a benchmark deep learning natural language processing approach (Clinical Bidirectional Encoder Representations from Transformers) to identify statin nonuse and reasons for statin nonuse from unstructured electronic health record data. Performance was evaluated against expert clinician review from manual annotation of clinical notes and compared with other natural language processing approaches. Of 33 461 patients with diabetes (mean age 59±15 years, 49% women, 36% White patients, 24% Asian patients, and 15% Hispanic patients), 47% (15 580) had no statin prescriptions. From unstructured data, Clinical Bidirectional Encoder Representations from Transformers accurately identified statin nonuse (area under receiver operating characteristic curve [AUC] 0.99 [0.98–1.0]) and key patient (eg, side effects/contraindications), clinician (eg, guideline‐discordant practice), and system reasons (eg, clinical inertia) for statin nonuse (AUC 0.90 [0.86–0.93]) and outperformed other natural language processing approaches. Reasons for nonuse varied by clinical and demographic characteristics, including race and ethnicity. Conclusions A deep learning algorithm identified statin nonuse and actionable reasons for statin nonuse in patients with diabetes. Findings may enable targeted interventions to improve guideline‐directed statin use and be scaled to other evidence‐based therapies.

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Changes in Statin Use Among U.S. Adults With Diabetes: A Population-Based Analysis of NHANES 2011–2018

Cited by 18 publications

References 15 publications

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Clinical encounter length and initiation of statin therapy for primary prevention among adults with elevated atherosclerotic cardiovascular disease risk

Identifying Reasons for Statin Nonuse in Patients With Diabetes Using Deep Learning of Electronic Health Records

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