The pandemic's impact on statin prescriptions
The COVID-19 pandemic made a noticeable impact on statin prescribing patterns, according to new data published in Circulation: Cardiovascular Quality and Outcomes.
To gain a better understanding of the structural changes in care delivery brought about by the pandemic, researchers evaluated statin prescribing rates for eligible patients before and during the COVID-19 pandemic at a time when care was being delivered through both in-person and telemedicine appointments.
The authors performed a retrospective analysis of 158 primary care physicians and 20,374 patient encounters at 28 Penn Medicine practice sites in Pennsylvania and New Jersey. All care was provided from October 2019 to September 2020, and the patients included in this study were eligible for a statin, but not actively prescribed one.
More than 50% of the patients were women, and the mean patient age was 65.8 years old. Patients who were allergic to statins or had a prior adverse reaction to statins were excluded.
In the analysis, clinical atherosclerotic cardiovascular disease diagnosis, history of familial hyperlipidemia, and a 10-year atherosclerotic cardiovascular disease risk score greater that 10% were observed in 26.7%, 0.5%, and 73.3% of the patient encounters, respectively.
As one might have expected, in-person visit volumes dropped during the start of the COVID-19 pandemic, but telemedicine visits also increased. In fact, telemedicine visits reached their highest in April 2020, accounting for 21.9% of all visits.
Looking specifically at in-person visits, the overall statin prescribing rate was 3.1%. The statin prescribing rate for telemedicine visits, meanwhile, was 3.2%.
In adjusted models, the authors observed that prescribing rates were noticeably higher during telemedicine visits than in-person visits between April 2020 to May 2020. There was no significant difference in prescribing rates between telemedicine and in-person visits during the rest of the study period.
“In this study, we found that overall statin prescribing rates were low, presenting an opportunity to improve the delivery of care,” lead author Atsushi Mizuno, MD, with Penn Medicine Nudge Unit, and colleagues wrote in the research letter. “Decreased rates of in-person visits during the COVID-19 pandemic were offset by an increased rate of telemedicine visits.”
Mizuno et al. also noted that their findings show the potential benefits of telemedicine, highlighting the time when prescribing rates were actually higher for telemedicine visits than in-person visits.
“This may indicate hyperlipidemia management is an effective use case for telemedical care delivery, particularly as the management of this condition does not always require a physical examination," the authors wrote. "Clinicians may also have had more time during telemedicine visits to address chronic conditions like hyperlipidemia as compared to in-person visits."
In conclusion, the authors asserted that future studies are needed to examine quality of care as telemedicine becomes more popular among clinicians and patients.