Key result
Web-based self-selection for nonprescription rosuvastatin matches clinician assessment in ~96% of cases.
Why the study?
Although statins reduce cardiovascular morbidity and mortality, only about half of eligible patients receive treatment, and safe consumer access could improve public health.
Does a technology-assisted self-selection approach provide concordant eligibility assessment for nonprescription statin therapy compared to clinician assessment in general participants?
Cross-Sectional (n=500)
Single-blind
Does a technology-assisted self-selection approach provide concordant eligibility assessment for nonprescription statin therapy compared to clinician assessment in general participants?
A web-based application for consumer self-selection of nonprescription statin therapy showed 96.2% concordance with clinician assessment, suggesting feasibility for safe consumer access.
Answers are grounded in this paper and cite their sources.
Suggests web-based screening may safely guide nonprescription statin access; leaves open whether this.
BACKGROUND: Although statins reduce cardiovascular morbidity and mortality, only about one-half of eligible patients receive treatment. Safe and appropriate consumer access to statins could have a significant positive public health impact. OBJECTIVES: This study compares the concordance between a participant and clinician assessment of eligibility for statin therapy using a technology-assisted approach. METHODS: A total of 500 participants, 83 with limited literacy, completed an at-home Web-based application to assess appropriateness for treatment with rosuvastatin 5 mg. The Web application is designed to assess eligibility for a moderate-intensity statin based on current guidelines and deny access to individuals with contraindications to rosuvastatin. Subsequently, participants visited a research site where clinicians, blinded to the information the participant entered, performed an independent Web application assessment. The Web application is programmed for 1 of 3 rosuvastatin treatment outcomes: "OK to use," "not right for you," or "ask a doctor." The primary endpoint was the percent of participants whose self-selected eligibility for nonprescription rosuvastatin was concordant with clinician assessment. RESULTS: For the primary endpoint, participant selection for statin therapy was concordant with clinician selection in 481 (96.2%) of 500 participants (95% confidence interval: 94.1%-97.7%), of whom 23 (4.6%) were deemed appropriate and 458 (91.6%) were deemed inappropriate for treatment. Discordance was due to incorrect self-selection ("OK to use") in 3 cases, incorrect rejection ("not right for you") in 14 cases and an incorrect "ask a doctor" outcome in 2 cases. CONCLUSIONS: The use of a technology-assisted approach to consumer self-selection for statin therapy resulted in participant self-selection that showed substantial agreement with clinician selection.
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Nissen et al. (2021) conducted a cross-sectional in Statin eligibility (n=500). Web-based application for self-selection of statin therapy vs. Clinician assessment was evaluated on percent of participants whose self-selected eligibility for nonprescription rosuvastatin was concordant with clinician assessment (95% CI 94.1-97.7). Participant self-selection for nonprescription rosuvastatin using a technology-assisted web application was concordant with clinician assessment in 96.2% of cases (95% CI 94.1-97.7%).
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