LIPID-LOWERING THERAPY AMONG CKD PATIENTS IN AUSTRALIAN GENERAL PRACTICE

MA KHANAM1, J RADFORD2, R CASTELINO2, MD JOSE2, A KITSOS2, J STANKOVICH2, ST ZAIDI2, L KINSMAN1, GM PETERSON2,3

1School of Health Sciences, University of Tasmania; 2School of Medicine, University of Tasmania; 3Faculty of Health, University of Tasmania, Sandy Bay, Tasmania

Aim: To examine the prescription patterns of lipid-lowering treatment among chronic kidney disease (CKD) patients within Australian general practice.

Background: A significant proportion of patients with early stages of CKD die of cardiovascular disease (CVD) before they develop end-stage kidney disease. Furthermore, abnormal lipid levels contribute to the progression of CKD. Lipid-lowering therapy reduces both kidney disease progression and the incidence of CVD in people with CKD.

Methods: MedicineInsight data 01/01/2013 to 01/06/2016 was used for this analysis. MedicineInsight is a primary care quality improvement initiative of NPS MedicineWise, that collects de-identified patient information, including prescriptions, from 557 participating general practices, providing a database of over 3.5 million Australians. We analysed the use of lipid-lowering therapy (at least one prescription during the study period) among CKD patients, with or without co-morbid conditions.

Results: 61,102 adult patients met the definition of CKD (two or more eGFR results <60ml/min/1.73m2, at least 90 days apart). The proportion of CKD patients (without co-morbidities) who had been prescribed lipid-lowering therapy was 42.7% (M41.2%, W43.7%), while prevalence of use was 69.7% among the CKD+CVD patient group (M75.3%, W64.7%), 72.2% among the CKD+Diabetes group (M70.4%, W73.6%), and 83.0% among the CKD+CVD+Diabetes group (M84.6%, W81.0%). With co-morbidities of CKD and CVD, women were 37.8% less likely to be prescribed lipid-lowering therapy compared to men (p <0.001). The use of lipid-lowering medication steadily increased with age in both genders until 80 years, then declined.

Conclusions: The rate of prescribing lipid-lowering medication in general practice-based CKD patients appears to be relatively high. However, there may be room for improvement, especially in patients without high-risk comorbidities, and females with co-existing CVD.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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