Department of Cardiac Sciences, Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada; Libin Cardiovascular Institute, Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada.
O'Brien Institute of Public Health Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada; Department of Pathology and Laboratory Medicine, Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada.
Clin Biochem. 2021 Oct;96:1-7. doi: 10.1016/j.clinbiochem.2021.06.004. Epub 2021 Jun 29.
The under-utilization of cardiovascular preventative therapy with statins warrants novel interventions to optimize prescriptions in at-risk patients. We investigated the role of a laboratory generated Framingham Risk Score (FRS) provided to primary care clinicians in changing statin use in a primary care setting.
Data was acquired from the electronic medical records of 1573 anonymized patients undergoing routine lipid testing. Follow-up statin use and low-density lipoprotein cholesterol levels were obtained for 2 years post intervention. FRS parameters were entered into a laboratory information system, and provided to ordering physicians along with the cholesterol profile and the appropriate current Canadian Dyslipidemia treatment recommendation in a single report. Statin prescription rates following the intervention were compared with historical use 6 months prior to the study.
A total of 1283 participants (mean age of 60 ± 11 years) had an FRS report and were considered for analysis. Two hundred individuals filled a statin prescription in the 6 months prior to their index lipid test, and an additional 84 filled a statin prescription following the intervention (42% increase). The relative and absolute increase in statin prescription was 47.3% and 13.6% in the high-risk group p < 0.001, 53.3% and 8.1% in the intermediate-risk group p < 0.001, and 17.0% and 1.42% in the low-risk group p = 0.008, respectively.
The use of the laboratory reported FRS was associated with a significant increase in the rate of statin prescription across all risk groups. The expansion of FRS reporting across other health regions would improve cardiovascular risk prevention.
他汀类药物在心血管预防治疗中的使用不足，需要新的干预措施来优化高危患者的处方。我们研究了在初级保健环境中向初级保健临床医生提供实验室生成的弗雷明汉风险评分（FRS）在改变他汀类药物使用方面的作用。
从 1573 名接受常规血脂检测的匿名患者的电子病历中获取数据。在干预后 2 年内获得后续他汀类药物使用情况和低密度脂蛋白胆固醇水平。FRS 参数输入实验室信息系统，并与胆固醇谱和当前加拿大血脂异常治疗建议一起在一份报告中提供给开单医生。干预后他汀类药物的处方率与研究前 6 个月的历史使用情况进行比较。
共有 1283 名参与者（平均年龄 60 ± 11 岁）进行了 FRS 报告并进行了分析。200 人在其索引血脂检测前 6 个月内开了他汀类药物处方，另有 84 人在干预后开了他汀类药物处方（增加 42%）。高危组的他汀类药物处方相对和绝对增加分别为 47.3%和 13.6%（p < 0.001），中危组分别为 53.3%和 8.1%（p < 0.001），低危组分别为 17.0%和 1.42%（p = 0.008）。
实验室报告的 FRS 的使用与所有风险组中他汀类药物处方率的显著增加相关。在其他卫生区域扩大 FRS 报告将改善心血管风险预防。
