Extended Statin Prescriptions Enhance Patient Care and Access

A recent study conducted by researchers at the Perelman School of Medicine at the University of Pennsylvania has revealed that changing the default prescription length for statins to 90 days can significantly reduce pharmacy visits and help address healthcare disparities.

Statins are essential medications used to manage cholesterol levels and reduce the risk of heart attacks and strokes. The study, published in JAMA Internal Medicine, demonstrated that by automatically setting the prescription length to 90 days in electronic health records, healthcare providers could facilitate better medication adherence among patients.

Managing chronic conditions can be challenging for patients, and this adjustment aims to simplify the process. According to the research, eliminating the need for patients to make multiple trips to the pharmacy each year can lower the risk of missed refills. The change has reportedly led to a decrease of eight pharmacy visits annually per medication, which could be crucial for those managing conditions like hypertension.

Prior studies indicated that patients with cardiovascular issues who adhered to their statin regimen had a significantly lower mortality risk. However, adherence rates remain a concern; only 64% of patients who had experienced a heart attack consistently took their prescribed statins, and the figure was even lower--at 38%--for diabetic patients.

The concept of 'nudging,' derived from behavioral science, plays a pivotal role in this initiative. By making the preferred choice--the 90-day prescription--the default option, healthcare providers can help guide patients toward better health outcomes without increasing their workload. The study found that the percentage of physicians prescribing 90-day statin supplies rose from 71% to 91% over the study period.

In total, the research resulted in 7,200 fewer 30-day prescriptions, indicating widespread acceptance of the new default. The success of this initiative has prompted Penn Medicine to consider applying a similar strategy to other chronic medications, like those for blood pressure and diabetes.

A notable aspect of the study was its impact on reducing disparities in prescription practices among different demographic groups. Initially, there were significant gaps in the likelihood of receiving 90-day prescriptions based on ethnicity and socioeconomic status. For instance, only about 50% of non-Hispanic white patients received 90-day prescriptions, compared to higher rates among their white counterparts.

However, by the end of the study, more than 90% of physicians across all demographic groups were prescribing 90-day supplies, showcasing the effectiveness of the intervention in promoting health equity.

The findings underscore the potential for simple changes in healthcare practices to lead to significant improvements in patient outcomes and access to necessary medications.