Patient Understanding of the Importance of Statin Use in the Perioperative Period

• Published in: Journal of cardiothoracic and vascular anesthesia 2015-06, Vol.29 (3), p.670-677
• Main Authors: Cubillo, Efrain I., MD, Rosenfeld, David M., MD, Hagstrom, Susan G., MD, Hu, Francis L., MD, Demenkoff, John H., MD, Cheng, Meng-Ru, MSPH, Trentman, Terrence L., MD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Atorvastatin Calcium - administration & dosage; cardioprotection; Comprehension; Critical Care; Female; Humans; hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitor; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Male; Medication Adherence; Middle Aged; Patient Participation - methods; Perioperative Care - methods; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; revised cardiac index; statins; Surveys and Questionnaires
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2014.10.021

Objective Perioperative hydroxy-3-methyl glutaryl coenzyme A reductase inhibitors (statins) have been shown to decrease morbidity and mortality after noncardiac surgery. The objective of this study was to assess patient understanding of the potential benefits of perioperative statins in a select population already on chronic therapy. A secondary aim was to determine the frequency with which patients recalled having a discussion with their provider regarding perioperative statins. Design Survey. Setting Teaching hospital. Participants Patients taking daily statins presenting to a preoperative medical evaluation clinic were offered a 12-question survey that assessed their understanding of the potential benefit of taking the medication in the perioperative period. Interventions None. Measurements and Main Results One hundred thirty-two patients completed the questionnaire. The mean age was 68.3 years (standard deviation, 9.0); 42% were female. The most frequent surgical referral to the clinic was orthopedics, at 36%. The most common statin prescribed was atorvastatin, in 35% of patients. Twenty-seven percent of patients (n = 36) recognized that perioperative statins are beneficial; 44% of these patients (n = 14) cited decreased cholesterol during the procedure as the reason, representing 12% of the total sampled population. Twenty-two percent (n = 8) of those recognizing the benefit of perioperative statins identified a decrease in the risk of heart attack or death as the reason. This represented only 6% of the total sample. One percent of surgeons mentioned statins in relation to the planned surgery; 2% of primary or prescribing physicians mentioned the medication in relation to surgery. Conclusions This study suggested low patient understanding of the potential importance and reasons for perioperative statins. In addition, this study also suggested that the information regarding the importance of perioperative statins is not being relayed to the patient at the level of the surgeon or primary care physician. All physicians involved in perioperative care can offer improved patient education to promote compliance with statin therapy in hopes of a favorable impact on perioperative outcomes.