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The Role of Usual Source of Care in Cholesterol Treatment

Departments of Family Medicine and Community and Preventive Medicine, University of Rochester, New York (PW, KF)
Department of Pediatrics, Center for Healthcare Policy and Research, University of California at Davis (DT)

Correspondence: Corresponding author: Kevin Fiscella, MD, MPH, 1381 South Ave, Rochester, NY 14620 (E-mail: Kevin_Fiscella{at}URMC.rochester.edu)

Background: A usual source of care (USOC) has been associated with improved preventive and chronic care, but its relationship with lipid management has not been well described. The objectives of this study were (1) to examine the association of USOC with statin use among persons meeting eligibility guidelines for treatment, and (2) to examine the association of USOC with low-density lipoprotein goal attainment among those receiving statins.

Methods: We examined statin use among adults aged 21 to 79 years who participated in the National Health and Nutrition Examination Survey, 1999 to 2006. We used criteria from the third Adult Treatment Panel about the treatment of high cholesterol to assess eligibility and the examined factors that predicted current use of statins. Among those currently taking statins, we assessed achievement of target low-density lipoprotein cholesterol based on the third Adult Treatment Panel's goals.

Results: Among the 12,979 participants, nearly 14% were eligible. Having a USOC was significantly associated with the use of statins among those who were eligible but not with goal attainment among those taking statins. Significant predictors of goal attainment were higher income and education and being in a more recent cohort.

Conclusion: In a national sample USOC was significantly associated with the use of statins among eligible adults but not with low-density lipoprotein cholesterol goal attainment for those using statins.

Key Words: Cholesterol • Usual Source of Care • Lipid • Statin • NHANES • Data Pooling

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