PMID- 32325358
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210716
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Print)
IS  - 0022-510X (Linking)
VI  - 414
DP  - 2020 Jul 15
TI  - Prevalence and predictors of statin utilization among patient populations at high 
      vascular risk in Ghana.
PG  - 116838
LID - S0022-510X(20)30174-X [pii]
LID - 10.1016/j.jns.2020.116838 [doi]
AB  - BACKGROUND: Inadequate implementation of evidence-based preventive measures for 
      individuals at high risk of cardiovascular disease (CVD) will only worsen the 
      current epidemic of CVDs in sub-Saharan Africa. We assessed rates and predictors 
      of statin utilization among two high CVD risk patient populations, people with 
      type 2 diabetes mellitus (T2DM) and those with stroke, encountered across five 
      hospitals in Ghana. METHODS: A cross-sectional study among 1427 patients with 
      T2DM and 159 stroke survivors encountered at 5 hospitals (1 primary-level, 2 
      secondary level and 2 tertiary level) in Ghana between July 2015 and June 2018. 
      We collected baseline demographic and clinical details including statin 
      prescription from medical records. Factors associated with statin prescription 
      among T2DM for primary prevention and stroke survivors for secondary prevention 
      were evaluated using multivariate logistic regression analysis. RESULTS: Among 
      patients with T2DM without CVDs, 240 (16.8%) were on statins for primary 
      prevention. Factors associated with statin use among diabetics expressed as aOR 
      (95% CI) were being treated at a tertiary level hospital 5.86 (3.22-10.68), 
      hypertension comorbidity 1.80 (1.25-2.60), and lower income 0.43 (0.26-0.70). 
      Among 159 stroke survivors, 22 (14.0%) were on statins with the following 
      associated factors: lower income 0.16 (0.03-0.77), secondary level vs. tertiary 
      level education 0.21 (0.05-0.97) and having T2DM 4.69 (1.63-13.49). CONCLUSION: 
      Approximately 1 in 6 individuals with T2DM without CVD and 1 in 7 stroke 
      survivors are prescribed statins in Ghana. Efforts to bridge this practice gap 
      and improve access to life saving preventative medications for CVD risk reduction 
      in low-and-middle income countries are urgently warranted.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Sarfo, Fred Stephen
AU  - Sarfo FS
AD  - Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Komfo Anokye 
      Teaching Hospital, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com.
FAU - Ovbiagele, Bruce
AU  - Ovbiagele B
AD  - Department of Neurology, University of California, San Francisco, USA.
LA  - eng
GR  - R21 NS094033/NS/NINDS NIH HHS/United States
PT  - Journal Article
DEP - 20200415
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
SB  - IM
MH  - *Cardiovascular Diseases/epidemiology/prevention & control
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2
MH  - Ghana/epidemiology
MH  - Humans
MH  - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Prevalence
MH  - Risk Factors
PMC - PMC7293931
MID - NIHMS1586221
OTO - NOTNLM
OT  - Primary prevention
OT  - Secondary prevention
OT  - Statin
OT  - Sub-Saharan Africa
COIS- Declaration of Competing Interest The authors do not have any competing 
      interests. Funding for this study was provided by MSD, Novartis, Pfizer, Sanofi 
      (each a Participant Company) and the Bill and Melinda Gates Foundation 
      (collectively, the Funders) through the New Venture Fund (NVF). The NVF is a 
      not-for-profit organization exempt as a public charity under section 501(c)(3) of 
      the United States Internal Revenue Code of 1986, and assumes financial management 
      of the study as a fiduciary agent and primary contractor for the Funders. 
      Consistent with anti-trust laws that govern industry interactions, each 
      Participant Company independently and voluntarily will continue to develop its 
      own marketing and pricing strategies reflecting, among other factors, the 
      Company's product portfolios and the patients it serves. For the avoidance of 
      doubt, the Participant Companies committed not to: (i) discuss any price or 
      marketing strategy that may involve any Project-related product; or (ii) make any 
      decision with respect to the presence, absence or withdrawal of any Participant 
      Company in or from any therapeutic area; or (iii) discuss the launching, 
      maintaining or withdrawing of any product in any market whatsoever. Each 
      Participant Company is solely responsible for its own compliance with applicable 
      anti-trust laws. The Funders were kept apprised of progress in developing and 
      implementing the study program in Ghana but had no role in study design, data 
      collection, data analysis or in study report writing. FSS and BO was supported by 
      National Institute of Health- National Institute of Neurological Disorders & 
      Stroke; R21 NS094033.
EDAT- 2020/04/24 06:00
MHDA- 2021/05/15 06:00
PMCR- 2021/07/15
CRDT- 2020/04/24 06:00
PHST- 2020/03/19 00:00 [received]
PHST- 2020/04/10 00:00 [revised]
PHST- 2020/04/14 00:00 [accepted]
PHST- 2020/04/24 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/04/24 06:00 [entrez]
PHST- 2021/07/15 00:00 [pmc-release]
AID - S0022-510X(20)30174-X [pii]
AID - 10.1016/j.jns.2020.116838 [doi]
PST - ppublish
SO  - J Neurol Sci. 2020 Jul 15;414:116838. doi: 10.1016/j.jns.2020.116838. Epub 2020 
      Apr 15.