Evidence mapPaperPMID 33849601Full record

SynthesisImplementation science : IS2021

Implementation strategies to improve statin utilization in individuals with hypercholesterolemia: a systematic review and meta-analysis.

Laney K Jones, Stephanie Tilberry, Christina Gregor, Lauren H Yaeger, Yirui Hu, Amy C Sturm, Terry L Seaton, Thomas J Waltz, Alanna K Rahm, Anne Goldberg and 4 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Implementation science : IS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
10.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
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  12. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

Laney K JonesGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA. Ljones14@geisinger.edu.ORCID 0000-0002-6182-5634
Stephanie TilberryGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA.
Christina GregorCenter for Pharmacy Innovation and Outcomes, Geisinger, Danville, PA, USA.
Lauren H YaegerBernard Becker Medical Library, Washington University in St. Louis, St. Louis, MO, USA.
Yirui HuPopulation Health Sciences, Geisinger, Danville, PA, USA.
Amy C SturmGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA.
Terry L SeatonUniversity of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, USA.
Thomas J WaltzEastern Michigan University, Ypsilanti, MI, USA.
Alanna K RahmGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA.
Anne GoldbergWashington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Ross C BrownsonPrevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, USA.
Samuel S GiddingGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA.
Marc S WilliamsGenomic Medicine Institute, Geisinger, 100 N Academy Ave., Danville, PA, 17822, USA.
Michael R GionfriddoCenter for Pharmacy Innovation and Outcomes, Geisinger, Danville, PA, USA.
Washington University in St. Louis · USEastern Michigan University · USGeisinger Health System · USGeisinger Medical Center · USUniversity of Health Sciences and Pharmacy · US

Funding

NHLBI NIH HHS K12 HL137942
6 · The paper itself

Abstract

backgroundNumerous implementation strategies to improve utilization of statins in patients with hypercholesterolemia have been utilized, with varying degrees of success. The aim of this systematic review is to determine the state of evidence of implementation strategies on the uptake of statins. METHODS AND

resultsThis systematic review identified and categorized implementation strategies, according to the Expert Recommendations for Implementing Change (ERIC) compilation, used in studies to improve statin use. We searched Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov from inception to October 2018. All included studies were reported in English and had at least one strategy to promote statin uptake that could be categorized using the ERIC compilation. Data extraction was completed independently, in duplicate, and disagreements were resolved by consensus. We extracted LDL-C (concentration and target achievement), statin prescribing, and statin adherence (percentage and target achievement). A total of 258 strategies were used across 86 trials. The median number of strategies used was 3 (SD 2.2, range 1-13). Implementation strategy descriptions often did not include key defining characteristics: temporality was reported in 59%, dose in 52%, affected outcome in 9%, and justification in 6%. Thirty-one trials reported at least 1 of the 3 outcomes of interest: significantly reduced LDL-C (standardized mean difference [SMD] - 0.17, 95% CI - 0.27 to - 0.07, p = 0.0006; odds ratio [OR] 1.33, 95% CI 1.13 to 1.58, p = 0.0008), increased rates of statin prescribing (OR 2.21, 95% CI 1.60 to 3.06, p < 0.0001), and improved statin adherence (SMD 0.13, 95% CI 0.06 to 0.19; p = 0.0002; OR 1.30, 95% CI 1.04 to 1.63, p = 0.023). The number of implementation strategies used per study positively influenced the efficacy outcomes.

conclusionAlthough studies demonstrated improved statin prescribing, statin adherence, and reduced LDL-C, no single strategy or group of strategies consistently improved outcomes.

trial registrationPROSPERO CRD42018114952 .

Indexed as

Hydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaImplementation strategiesMeta-analysisStatinUptake

Identifiers

PMID33849601
PMCPMC8045284
OpenAlexW3156002417

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.