(1051) A Retrospective Evaluation of Statin Therapeutic Intensity in Patients with Diabetes-specific Risk Enhancers at a Federally Qualified Health Center

Objectives: Atherosclerotic cardiovascular disease (ASCVD) is more common among patients with diabetes than those without diabetes. Current AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION (ACC/AHA) guidelines recommend at least moderate-INTENSITY statin therapy in patients with diabetes as primary prevention, regardless of their ASCVD Risk Score. PER THE ACC/AHA GUIDELINES, MOST PATIENTS AGE 40-75 WITH DIABETES ARE AT INTERMEDIATE OR HIGH RISK (ASCVD ≥7.5%) OF HAVING AN ASCVD EVENT. AT A MINIMUM, MODERATE-INTENSITY STATIN THERAPY IS INDICATED FOR PRIMARY PREVENTION FOR THESE PATIENTS. However, high-intensity statin therapy may be necessary to further reduce the risk of an ASCVD event in patients with certain diabetes-specific risk enhancers independent of other diabetes risk factors. The risk enhancers include duration of disease, presence of albuminuria (≥30 mcg of albumin/mg of creatinine), ESTIMATED GLOMERULAR FILTRATION RATE (eGFR) < 60 mL/min/1.73 m2, retinopathy, neuropathy, and AN ANKLE-BRACHIAL INDEX (ABI) < 0.9.

• The purpose of this study is to analyze whether patients with type 2 diabetes are prescribed the guideline-recommended statin therapeutic intensity based on the presence of diabetes-specific risk enhancers at a federally qualified health center (FQHC).

• The primary objective is to QUANTIFY THE NUMBER OF PATIENTS ON GUIDELINE-RECOMMENDED STATIN THERAPEUTIC INTENSITY IN PATIENTS WITH DIABETES TO DETERMINE THE RATE OF GUIDELINE ACCEPTANCE AT AN FQHC.

Methods: This single-center RETROSPECTIVE study includes patients aged 40-75 with a type 2 diabetes diagnosis and at least 1 diabetes-specific risk enhancer (retinopathy, neuropathy, PERIPHERAL ARTERY DISEASE (PAD) diagnosis, MALB >30, eGFR < 60 mL/min/1.73 m2) and have an active prescription for a statin of any strength or intensity, between January 1, 2023, and September 1, 2023. Patients < 40 or >75 YEARS OLD, have been diagnosed with type 1 or gestational diabetes, are pregnant, or have known ASCVD will be excluded. DATA FOR THIS PROJECT WILL BE EXTRACTED BY AN INFORMATICS PHARMACIST WHO WILL NOT BE INVOLVED IN ANY DATA ANALYSIS. ALL DATA ANALYSIS AND CHART REVIEW WILL BE PERFORMED BY THE PRIMARY INVESTIGATOR (PI) ON-SITE AT THE FQHC. ONE COMPUTER WITH AN ENCRYPTED HARD DRIVE WILL BE USED TO COLLECT AND STORE ALL DATA. PHARMACY CLAIMS DATA AND FILL HISTORY MAY BE ACCESSED DURING CHART REVIEW TO CONFIRM THE PRESCRIBING OF A STATIN MEDICATION. PATIENTS WHO ARE TAKING GUIDELINE-RECOMMENDED STATIN THERAPY ARE BEING COMPARED TO THOSE WHO ARE INDICATED FOR BUT HAVE NOT BEEN PRESCRIBED STATIN THERAPY. Both groups are independent of one another. Data analysis will be performed with a chi-square test TO COMPARE THE PERCENTAGE OF PATIENTS ON STATIN THERAPY AND THOSE WHO ARE INDICATED FOR BUT HAVE NOT BEEN PRESCRIBED STATIN THERAPY. FOLLOWING THE COMPLETION OF CHART REVIEW AND DATA ANALYSIS, THE PI WILL CONTACT PRIMARY CARE PROVIDERS FOR PATIENTS WHO ARE INDICATED FOR STATIN THERAPY TO RECOMMEND INITIATING OR OPTIMIZING STATIN THERAPY.

Results: It is hypothesized that patients at an FQHC who have a type 2 diabetes diagnosis and concomitant diabetes-specific risk enhancers are prescribed the guideline-recommended statin therapeutic intensity in primary prevention. IF IT IS DETERMINED THAT THEY ARE NOT BEING UTILIZED, THE POTENTIAL REASONS FOR THIS DEFICIT WILL BE EVALUATED. This information can be studied to inform prescribers on guideline-directed statin therapy AND MAKE PRESCRIBING RECOMMENDATIONS to further improve outcomes. IF A DEFICIT IS DISCOVERED, CONTINUING EDUCATION RESOURCES COULD BE CREATED AND DISSEMINATED TO OTHER FQHCS OF SIMILAR SIZE, POPULATIONS SERVED, AND OPERATING PROCEDURES TO IMPROVE OUTCOMES ACROSS FACILITIES.

Conclusions: N/A