Time trends analysis of statin prescription prevalence, therapy initiation, dose intensity, and utilization

Abstract Background Statin remains a mainstay in the prevention and treatment of cardiovascular disease. Statin utilization has evolved over time in many counties, but data on this topic from China are quite limited. This study aimed to investigate the changing trends of statins prescription, as well as detail the statin utilization through a successive longitudinal study. Methods Prescription database was established based on electronic health records retrieved from the hospital information system of Jinshan Hospital, Fudan University from January 2012 to December 2018 in Shanghai, China. The prescription rates and proportions of different statin types and doses among all patients were examined. Sub-analyses were performed by stratified by age, gender, dose intensity, and preventative intervention.Results During the study period, a total of 51,083 patients exposed to statins were included in this study (mean [SD] age, 59.78 [±13.16] years; 53.60% male, n =27, 378). The overall statins prescription rate in patients increased from 2012 (1.24%, 95% CI: 1.21%-1.27) to 2018 (3.16%, 95% CI: 3.11%-3.20%), P <0.001. Over 90% of patients were given a moderate dose of statins. Our study has witnessed a significant rise in statin therapy in primary and secondary prevention. Patients with a history of coronary or cerebrovascular events were more likely to be prescribed with statins for preventative intervention. Conclusions In conclusion, statins were frequently prescribed and steadily increased over time. However, in clinical practice, statins prescription rate in patients may be sub-optimal in local residents. A coordinated effort among the patient, clinical pharmacist, stakeholders and health system is still needed to improve statin utilization accordingly. Keywords: statins, prevalence, cardiovascular disease, initiation, preventative intervention.