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Exploring patient demographic and clinical characteristics associated with lipid-lowering pharmacotherapy use in primary care.

https://arctichealth.org/en/permalink/ahliterature161756
Source
Clin Invest Med. 2007;30(2):E63-9
Publication Type
Article
Date
2007
Author
Pendar Farahani
Mitchell Levine
Kathryn Gaebel
Jacques LeLorier
Sylvie Perrault
Jane Gillis
Judith Soon
Author Affiliation
Centre for Evaluation of Medicines, St. Joseph's Healthcare and McMaster University, Hamilton, Ontario, Canada.
Source
Clin Invest Med. 2007;30(2):E63-9
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
British Columbia
Canada
Cardiovascular Diseases - blood - etiology - prevention & control
Cholesterol, LDL - blood
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - blood - drug therapy
Hypolipidemic Agents - therapeutic use
Interviews as Topic
Male
Middle Aged
Nova Scotia
Ontario
Pharmacies - statistics & numerical data
Primary Health Care - statistics & numerical data
Quebec
Risk factors
Abstract
Lipid-lowering therapeutics, particularly HMG Co-A reductase inhibitors, can be beneficial in primary and secondary cardiovascular prevention. The Canadian population frequently uses these medications but the manner in which they are used in community-based practice is unknown.
To assess the patient characteristics associated with lipid lowering drug use in community-based clinical practice across four geographic regions in Canada. To assess amongst lipid-lowering drugs users the proportion of patients that would meet accepted dyslipidemia management guidelines. To assess the community-based effectiveness of anti-hyperlipidemic drugs.
Patients filling a prescription for any anti-hyperlipidemia therapy in selected pharmacies in Ontario (ON), Quebec (PQ), British Columbia (BC) and Nova Scotia (NS). All eligible patients were interviewed over the telephone. Physicians who were providing healthcare to the participating patients were requested to provide information from the patient's medical record.
The mean patient age was > 60 yr in all four provinces. There were some differences amongst the four provinces pertaining to patient characteristics, prescription patterns and therapeutic indicators, but not to outcomes. Anti-hyperlipidemia therapy was associated with a 1.81 mmol/L decrease in LDL-Cholesterol (P
PubMed ID
17716543 View in PubMed
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Goal attainment for multiple cardiovascular risk factors in community-based clinical practice (a Canadian experience).

https://arctichealth.org/en/permalink/ahliterature152438
Source
J Eval Clin Pract. 2009 Feb;15(1):212-6
Publication Type
Article
Date
Feb-2009
Author
Pendar Farahani
Mitchell Levine
Author Affiliation
Center for Evaluation of Medicines, St. Joseph's Healthcare, Hamilton, ON, Canada. farahap@mcmaster.ca
Source
J Eval Clin Pract. 2009 Feb;15(1):212-6
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cardiovascular Diseases - complications - drug therapy
Community health centers - standards
Comorbidity
Cross-Sectional Studies
Female
Humans
Male
Medical Audit
Middle Aged
Risk assessment
Risk factors
Risk Reduction Behavior
Abstract
The primary goal in the clinical management of atherosclerotic cardiovascular (CV) disease is to reduce major CV risk factors. A single risk factor approach has been traditionally used for demonstrating effectiveness of therapeutic interventions designed to reduce CV risk in clinical trials, but a global CV risk reduction approach should be adopted when assessing effectiveness in the clinical practice setting.
To explore combined goal achievement for low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose and systolic-diastolic blood pressure, in patients with dyslipidemia on pharmacotherapy in community-based clinical practices across Canada.
In a cross-sectional study, patients filling a prescription for any antihyperlipidemia therapy in selected pharmacies in Ontario, Quebec, British Columbia and Nova Scotia were recruited. Family physicians of the participating patients were requested to provide information from the patient's medical record. Ten-year CV risk was identified for each patient according to the Framingham criteria.
High-risk patients comprised 52% of the patient population; 34% were moderate-risk and 14% were low-risk. Patients had a mean of 2.8 CV risk factors; high-risk 3.7, moderate-risk 2.3 and low-risk 1.2. LDL-C goal attainment was observed in 62%, 79% and 96% of patients in high-risk, moderate-risk and low-risk strata respectively. BP goal was achieved in high-risk patients 58%, moderate-risk 83% and low-risk 95%. Glucose levels were below the threshold in 91% of patients. Complete global CV risk reduction was achieved in only 21%, 66% and 92% of high-risk, moderate-risk and low-risk strata respectively.
This study illustrates that many patients with dyslipidemia in the Canadian population, and in particular the high-risk patients, did not meet the therapeutic targets for specific CV risk factors according to the Canadian guidelines. Overall, 54% of patients failed to achieve a state of complete global CV risk reduction.
PubMed ID
19239605 View in PubMed
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Household income and LDL-C goal attainment in patients with diabetes and dyslipidemia in a Canadian dataset.

https://arctichealth.org/en/permalink/ahliterature256824
Source
Clin Invest Med. 2014;37(1):E47-52
Publication Type
Article
Date
2014
Author
Pendar Farahani
Mitchell Levine
Author Affiliation
. pendar.farahani@queensu.ca.
Source
Clin Invest Med. 2014;37(1):E47-52
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cholesterol, LDL - blood
Cohort Studies
Databases, Factual
Diabetes Complications - blood - drug therapy - economics
Dyslipidemias - blood - drug therapy - economics
Female
Health Status Disparities
Humans
Hypolipidemic Agents - economics - therapeutic use
Income
Male
Middle Aged
Abstract
There is evidence of a social disparity pertaining to the epidemiology and burden of illness of diabetes. The purpose of this study was to assess the association between household income strata and therapeutic goal achievement rates for LDL-cholesterol (LDL-C) (
PubMed ID
24502811 View in PubMed
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