The use of combination lipid therapy in a county health system

Margaret Youngmi Pio, Erin Marie Piszczor, Marissa Escobar Quinones, Steven Micheal Boatright, Diem Hong Chow, Jeffrey Lynn Hulstein, Elizabeth Moss, Annie Chathanatt Mathew, Nitin Budhwar

Research output: Contribution to journalArticle

Abstract

Background: With the paucity of clinical outcomes trials and guidelines to make compelling recommendations regarding the treatment of dyslipidemia beyond statin monotherapy, we present a descriptive analysis of the combination lipid-lowering therapies being used at a large county hospital system. Objective: To provide a descriptive evaluation of the comparative effectiveness and safety of various combination lipid therapies in conjunction with a statin. Methods: Patients of a county health system who received at least 3 months of combination lipid therapy in conjunction with a statin during a 1-year period were eligible for inclusion in this retrospective chart review. The main outcome was a descriptive analysis of the comparative effectiveness among combination lipid therapies, as evidenced by fasting lipid panels. Results: A total of 834 patients were included in the analysis. Approximately 88% were on 1 additional lipid-modifying agent beyond a statin; 2 or 3 additional medications were much less common. Fish oils and fibrates were the most common nonstatin agents used, comprising approximately 85% of the combination therapies. Approximately 17% of patients had all 4 lipids at goal. A majority of patients were at goal for low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), and total cholesterol, but a large proportion were not at goal for HDL-C and triglycerides. No statistically significant differences were found among therapies for effectiveness related to lipid goals, medication adherence, or safety. The chart review did not find an appreciable number of adverse events. The overall adherence rate was subpar at 56% and varied modestly among treatments. Conclusions: This retrospective analysis found no significant differences in effectiveness, adherence, and safety among the combination lipid therapies used in a county health system. Further research is warranted to elucidate the recommended approach to using combination lipid therapies.

Original languageEnglish (US)
Pages (from-to)227-233
Number of pages7
JournalJournal of Pharmacy Technology
Volume28
Issue number6
StatePublished - Nov 2012

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Lipids
Health
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Safety
Fibric Acids
County Hospitals
Medication Adherence
Fish Oils
Dyslipidemias
LDL Cholesterol
Fasting
Triglycerides
Cholesterol
Clinical Trials
Guidelines
Research

ASJC Scopus subject areas

  • Pharmaceutical Science

Cite this

Pio, M. Y., Piszczor, E. M., Quinones, M. E., Boatright, S. M., Chow, D. H., Hulstein, J. L., ... Budhwar, N. (2012). The use of combination lipid therapy in a county health system. Journal of Pharmacy Technology, 28(6), 227-233.

The use of combination lipid therapy in a county health system. / Pio, Margaret Youngmi; Piszczor, Erin Marie; Quinones, Marissa Escobar; Boatright, Steven Micheal; Chow, Diem Hong; Hulstein, Jeffrey Lynn; Moss, Elizabeth; Mathew, Annie Chathanatt; Budhwar, Nitin.

In: Journal of Pharmacy Technology, Vol. 28, No. 6, 11.2012, p. 227-233.

Research output: Contribution to journalArticle

Pio, MY, Piszczor, EM, Quinones, ME, Boatright, SM, Chow, DH, Hulstein, JL, Moss, E, Mathew, AC & Budhwar, N 2012, 'The use of combination lipid therapy in a county health system', Journal of Pharmacy Technology, vol. 28, no. 6, pp. 227-233.
Pio MY, Piszczor EM, Quinones ME, Boatright SM, Chow DH, Hulstein JL et al. The use of combination lipid therapy in a county health system. Journal of Pharmacy Technology. 2012 Nov;28(6):227-233.
Pio, Margaret Youngmi ; Piszczor, Erin Marie ; Quinones, Marissa Escobar ; Boatright, Steven Micheal ; Chow, Diem Hong ; Hulstein, Jeffrey Lynn ; Moss, Elizabeth ; Mathew, Annie Chathanatt ; Budhwar, Nitin. / The use of combination lipid therapy in a county health system. In: Journal of Pharmacy Technology. 2012 ; Vol. 28, No. 6. pp. 227-233.
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