Practising physician at Seven Oaks Emergency Department in Winnipeg, Man.
Director of the Manitoba Primary Care Research Network and Assistant Professor in the Department of Family Medicine at the University of Manitoba.
Can Fam Physician. 2017 Nov;63(11):e495-e503. Epub 2017 Nov 14.
To determine the proportion of patients receiving statins for primary or secondary prevention of cardiovascular disease (CVD), as well as to describe lipid-screening trends.
Retrospective chart review using the Manitoba Primary Care Research Network repository.
Manitoba.
A total of 149 262 patients.
Proportion of patients who were taking statins for primary or secondary prevention of cardiovascular disease (CVD), who did not have evidence of CVD recorded in their charts, and who underwent lipid screening; distribution of statins among age groups; and the proportion of patients eligible for lipid screening when the age cutoffs of the 2012 and 2016 Canadian Cardiovascular Society guidelines were applied.
Of the 149 262 patients, 139 025 (93%) did not have CVD recorded in their electronic medical records and made up the primary prevention group; of these 139 025 patients, 5955 (4%) were taking statins. Also in the primary prevention group, 14 814 (11%) patients were 75 years of age and older; of these patients, 1374 (9%) were taking statins. A total of 10 237 of the 149 262 (7%) patients had CVD recorded in their charts (secondary prevention group); 3013 (29%) of these patients were taking statins. When the 2016 Canadian Cardiovascular Society guidelines age cutoffs were applied, 56% of patients (83 119 of 149 262) were eligible for lipid screening, and 31% (26 024 of 83 119) of them had evidence of screening in the past 5 years. Of the total population of those aged 75 and older, 28% (5597 of 20 188) had undergone lipid screening. Of the total population taking statins, 28% (2481 of 8968) had undergone lipid testing while taking statins.
In Manitoba, less than 5% of the primary prevention population and less than 30% of the secondary prevention population had received repeat statin prescriptions from their primary care providers. This represents a possible practice gap that warrants future research, as statins offer considerable morbidity and mortality benefits in these patients.
确定接受他汀类药物用于心血管疾病（CVD）一级或二级预防的患者比例，并描述血脂筛查趋势。
使用马尼托巴初级保健研究网络存储库进行回顾性图表审查。
马尼托巴省。
共有 149262 名患者。
正在接受他汀类药物一级或二级预防 CVD 治疗的患者比例，这些患者的病历中没有 CVD 记录，并且接受了血脂筛查；不同年龄组他汀类药物的分布情况；以及当应用 2012 年和 2016 年加拿大心血管学会指南的年龄截止值时，有资格进行血脂筛查的患者比例。
在 149262 名患者中，有 139025 名（93%）患者的电子病历中未记录 CVD，他们构成了一级预防组；在这 139025 名患者中，有 5955 名（4%）正在服用他汀类药物。此外，在一级预防组中，有 14814 名（11%）患者年龄在 75 岁及以上；在这些患者中，有 1374 名（9%）正在服用他汀类药物。共有 10237 名患者（7%）的病历中记录了 CVD（二级预防组）；这些患者中有 3013 名（29%）正在服用他汀类药物。当应用 2016 年加拿大心血管学会指南的年龄截止值时，56%的患者（149262 名中的 83119 名）有资格进行血脂筛查，而过去 5 年内有 31%（83119 名中的 26024 名）的患者有筛查证据。在所有 75 岁及以上的人群中，28%（20188 名中的 5597 名）接受了血脂筛查。在服用他汀类药物的人群中，28%（8968 名中的 2481 名）在服用他汀类药物的同时接受了血脂检测。
在马尼托巴省，不到 5%的一级预防人群和不到 30%的二级预防人群从初级保健提供者那里获得了重复的他汀类药物处方。这代表了一个可能存在的实践差距，值得进一步研究，因为他汀类药物在这些患者中具有显著的发病率和死亡率益处。
