Beliefs, risk perceptions, and lipid management among patients with and without diabetes: Results from the PALM registry

Authors

Angela Lowenstern, Duke Clinical Research Institute, USA.
Shuang Li, Duke Clinical Research Institute, USA.
Salim S. Virani, Baylor College of Medicine, USA.Follow
Ann Marie Navar, Duke Clinical Research Institute, USA.
Zhuokai Li, Duke Clinical Research Institute, Durham, USA.
Jennifer G. Robinson, University of Iowa, USA.
Veronique L. Roger, Mayo Clinic, USA.
Anne C. Goldberg, Washington University, USA.
Andrew Koren, NJ Washington University, USA.
Michael J. Louie, egeneron Pharmaceuticals, Inc., USA.

Document Type

Article

Department

Office of the Provost; Cardiology

Abstract

Background: Intensive lipid management is critical to reduce cardiovascular (CV) risk for patients with diabetes mellitus (DM).
Methods: We performed an observational study of 7628 patients with (n = 2943) and without DM (n = 4685), enrolled in the Provider Assessment of Lipid Management (PALM) registry and treated at 140 outpatient clinics across the United States in 2015. Patient self-estimated CV risk, patient-perceived statin benefit and risk, observed statin therapy use and dosing were assessed.
Results: Patients with DM were more likely to believe that their CV risk was elevated compared with patients without DM (39.1% vs 29.3%, P < .001). Patients with DM were more likely to receive a statin (74.2% vs 63.5%, P < .001) but less likely to be treated with guideline-recommended statin intensity (36.5% vs 46.9%, P < .001), driven by the low proportion (16.5%) of high risk (ASCVD risk ≥7.5%) primary prevention DM patients treated with a high intensity statin. Patients with DM treated with guideline-recommended statin intensity were more likely to believe they were at high CV risk (44.9% vs 38.4%, P = .005) and that statins can reduce this risk (41.1% vs 35.6%, P = .02), compared with patients treated with lower than guideline-recommended statin intensity. Compared with patients with an elevated HgbA1c, patients with well-controlled DM were no more likely to be on a statin (77.9% vs 79.3%, P = .43).
Conclusions: In this nationwide study, the majority of patients with DM were treated with lower than guideline-recommended statin intensity. Patient education and engagement may help providers improve lipid therapy for these high-risk patients.

Comments

Pagination is not provided by the author/publisher. This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

American Heart Journal

DOI

10.1016/j.ahj.2020.04.018

Recommended Citation

Lowenstern, A., Li, S., Virani, S. S., Navar, A. M., Li, Z., Robinson, J. G., Roger, V. L., Goldberg, A. C., Koren, A., Louie, M. J. (2020). Beliefs, risk perceptions, and lipid management among patients with and without diabetes: Results from the PALM registry. American Heart Journal, 225, 88-96.
Available at: https://ecommons.aku.edu/provost_office/588