Best Practice Advisory to Initiate High-Intensity Statin Therapy in Patients With Peripheral Artery Disease

Best Practice Advisory to Initiate High-Intensity Statin Therapy in Patients With Peripheral Artery Disease

The purpose of this study is to understand how a Best Practice Advisory (BPA) for high-intensity statin therapy in patients with Peripheral Artery Disease impacts prescription rates.

The central hypothesis is that an automated best practice advisory embedded within the electronic medical record (EMR) will improve prescription of high-intensity statins among hospitalized patients with Peripheral Artery Disease (PAD).

Aim 1: To assess the impact of an automated best practice advisory, deployed as part of the standard hospital discharge workflow within the electronic medical record, on high-intensity statin prescription among hospitalized patients with PAD.

Aim 2: To assess the impact of an automated best practice advisory, deployed as part of the standard hospital discharge workflow within the electronic medical record, on short-term cardiovascular outcomes among hospitalized patients with PAD.

Inclusion Criteria:

• Primary hospital diagnosis of PAD defined by ICD/CPT codes
• Inpatient status at the adult hospital at Vanderbilt University Medical Center
• Not currently prescribed a high-intensity statin (atorvastatin 40-80mg daily or rosuvastatin 20-40mg daily)

Exclusion Criteria:

• On comfort measures
• History of statin allergy or intolerance recorded in the EMR
• History of rhabdomyolysis defined by International Classification of Diseases/Current Procedural Terminology (ICD/CPT) codes
• History of hepatitis A, B, or C defined by ICD/CPT codes
• Pregnant
• Aspartate aminotransferase >120 units/L within 30 days of alert
• Alanine aminotransferase >165 units/L within 30 days of alert
• Primary hospital diagnosis of acute myocardial infarction defined by ICD/CPT codes
• Primary hospital diagnosis of acute stroke defined by ICD/CPT codes