Department of Family Medicine, University of Rochester, New York, USA.
J Am Board Fam Med. 2010 Mar-Apr;23(2):179-85. doi: 10.3122/jabfm.2010.02.090084.
A usual source of care (USOC) has been associated with improved preventive and chronic care, but its relationship with lipid management has not been well described. The objectives of this study were (1) to examine the association of USOC with statin use among persons meeting eligibility guidelines for treatment, and (2) to examine the association of USOC with low-density lipoprotein goal attainment among those receiving statins.
We examined statin use among adults aged 21 to 79 years who participated in the National Health and Nutrition Examination Survey, 1999 to 2006. We used criteria from the third Adult Treatment Panel about the treatment of high cholesterol to assess eligibility and the examined factors that predicted current use of statins. Among those currently taking statins, we assessed achievement of target low-density lipoprotein cholesterol based on the third Adult Treatment Panel's goals.
Among the 12,979 participants, nearly 14% were eligible. Having a USOC was significantly associated with the use of statins among those who were eligible but not with goal attainment among those taking statins. Significant predictors of goal attainment were higher income and education and being in a more recent cohort.
In a national sample USOC was significantly associated with the use of statins among eligible adults but not with low-density lipoprotein cholesterol goal attainment for those using statins.
通常的医疗来源(USOC)与改善预防和慢性病护理有关,但它与脂质管理的关系尚未得到很好的描述。本研究的目的是:(1)检查符合治疗标准的人群中 USOC 与他汀类药物使用之间的关系,以及(2)检查接受他汀类药物治疗的人群中 USOC 与低密度脂蛋白目标达标之间的关系。
我们检查了 1999 年至 2006 年期间参加国家健康和营养调查的 21 至 79 岁成年人中他汀类药物的使用情况。我们使用第三版成人治疗专家组关于高胆固醇治疗的标准来评估合格情况,并检查了预测当前他汀类药物使用的因素。在那些正在服用他汀类药物的患者中,我们根据第三版成人治疗专家组的目标评估了目标低密度脂蛋白胆固醇的达标情况。
在 12979 名参与者中,近 14%符合条件。在符合条件的人群中,有 USOC 与他汀类药物的使用显著相关,但与服用他汀类药物的患者的目标达标情况无关。目标达标率的显著预测因素是更高的收入和教育水平以及处于较新的队列中。
在全国样本中,USOC 与符合条件的成年人使用他汀类药物显著相关,但与使用他汀类药物的患者的低密度脂蛋白胆固醇目标达标情况无关。