Evaluation of the Therapeutic Pattern and Pharmaco-Utilization in Hypercholesterolemic Patients Treated with Statins: A Retrospective Study on Italian Real-World Data

• Published in: Risk management and healthcare policy Vol. 15; pp. 1483 - 1489
• Main Authors: Perrone, Valentina, Giacomini, Elisa, Sangiorgi, Diego, Andretta, Margherita, Bartolini, Fausto, Lupi, Alessandro, Ferrante, Fulvio, Palcic, Stefano, Re, Davide, Degli Esposti, Luca
• Format: Journal Article
• Language: English
• Published: Macclesfield Dove Medical Press Limited 01.01.2022; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Age; Analysis; Analysis and chemistry; Blood; Cardiovascular disease; Care and treatment; Cholesterol; clinical practice; Comorbidity; Diabetes; Diagnostic tests; Disease prevention; Health aspects; Hospitalization; Hypercholesterolemia; lipid-lowering agents; Lipids; Low density lipoproteins; Patients; pharmacoutilization; Plasma; Prevention; real-world evidence; Sensitivity analysis; Short Report; Statins
• ISSN: 1179-1594; 1179-1594
• DOI: 10.2147/RMHP.S358015

Purpose: The study aimed to analyze, in hypercholesterolemic patients under statin medication, patient characteristics and their lipid profile at baseline, the therapeutic pathway, and the pharmaco-utilization, using real-world data in Italy. Patients and Methods: A retrospective study was conducted using administrative databases of a sample of entities covering 6.5 million health-assisted individuals. Between January 2010 and June 2019, patients with non-familial hypercholesterolemia (nFH) were identified by 1) [greater than or equal to]1 low-density lipoprotein cholesterol (LDL-C) measurement (LDL-C assessment date was the index-date) and 2) statin prescription during 6 months before the index-date (pharmaco-utilization period). FH patients were defined by LDL-C evaluation, statin treatment during the pharmaco-utilization period, and a score [greater than or equal to]6 according to the Dutch Lipid Clinic Network criteria. nFH patients were divided into four exclusive cohorts based on CV-risk class: 1) with previous CV disease (CVD); 2) with diabetes mellitus; 3) with mixed-dyslipidemia diagnosis; 4) in primary-prevention. Based on LDL-C index values, patient was defined with LDL-C "controlled" if its levels were [less than or equal to]70mg/dl (CVD), [less than or equal to]100mg/dl (diabetes, FH), [less than or equal to]130mg/dl (mixed-dyslipidemia, primary-prevention). Results: Overall 164,161 nFH patients were included (mean age 72 years, 51% male); of these, 46,782 (28.5%) were CVD (mean age 74 years, 66% male), 34,803 (21.2%) were diabetic (mean age 72 years, 51% male), 1617 (1%) were with mixed-dyslipidemia (mean age 71 years, 48% male) and 80,959 (49.3%) were in primary-prevention (mean age 71 years, 42% male). The proportion of nFH patients with controlled LDL-C was 41.2% for CVD, 73.6% for diabetic, 80.7% for mixed-dyslipidemia, and 79.5% for primary-prevention patients; 49% of nFH patients were adherent to therapy. Overall, 1287 FH patients (mean age 64 years, 42% male) were included; in 39.2% of the patients, LDL-C was controlled, and 44% of the patients were adherent to therapy. Conclusion: The results of this study highlighted non-optimal therapeutic management of hypercholesterolemic patients in Italian clinical practice, with a notable quote of patients non-adherent to therapy. Keywords: lipid-lowering agents, pharmacoutilization, real-world evidence, clinical practice