A Technology-Assisted Web Application for Consumer Access to a Nonprescription Statin Medication

Authors

• Steven E Nissen
• Howard G Hutchinson
• Kathy Wolski
• Karol Watson
• Seth S Martin
• Erin D Michos
• William S Weintraub
• Melanie Morris
• Leslie Cho
• Luke Laffin
• Douglas Jacoby
• Christie M Ballantyne
• Jan Ekelund
• Filip Birve
• Venu Menon
• Michelle Strzelecki
• Paul M Ridker

Language

English

Publication Date

5-28-2024

Journal

Journal of the American College of Cardiology

DOI

10.1016/j.jacc.2024.03.388

PMID

38599257

Abstract

Background: Although statins reduce adverse cardiovascular outcomes, less than one-half of eligible patients receive treatment. A nonprescription statin has the potential to improve access to statins.

Objectives: This study sought to assess concordance between clinician and consumer assessment of eligibility for nonprescription statin treatment using a technology assisted self-selection Web application (Web App) and evaluate effect on low-density lipoprotein cholesterol (LDL-C) levels.

Methods: This study was a prospective actual use 6-month study to evaluate use of a Web App to qualify participants without a medical background for a moderate-intensity statin based on current guidelines. Participants entered demographic information, cholesterol values, blood pressure, and concomitant medications into the Web App, resulting in 3 possible outcomes: "do not use," "ask a doctor," and "OK to use."

Results: The study included 1,196 participants, with a median age of 63 years (Q1-Q3: 57-68 years); 39.6% were women, 79.3% were White, 11.7% were Black, and 4.1% had limited literacy. Mean LDL-C was 139.6 ± 28.3 mg/dL and the median calculated 10-year risk of atherosclerotic cardiovascular disease was 10.1% (Q1-Q3: 7.3%-14.0%). Initial Web App self-selection resulted in an outcome concordant with clinician assessment in 90.7% (95% CI: 88.9%-92.3%) of participants, and 98.1% (95% CI: 97.1%-98.8%) had a concordant final use outcome during treatment. Mean percent change in LDL-C was -35.5% (95% CI: -36.6% to -34.3%). Serious adverse events occurred in 27 (2.3%) participants, none related to the study drug.

Conclusions: In this actual use study, a technology-assisted Web App allowed >90% of consumers to correctly self-select for statin use and achieve clinically important LDL-C reductions. (Technology-Assisted Cholesterol Trial in Consumers [TACTiC]; NCT04964544).

Keywords

Humans, Female, Male, Middle Aged, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Aged, Prospective Studies, Internet, Nonprescription Drugs, Cholesterol, LDL, cholesterol, consumers, technology

Published Open-Access

yes

Recommended Citation

Nissen, Steven E; Hutchinson, Howard G; Wolski, Kathy; et al., "A Technology-Assisted Web Application for Consumer Access to a Nonprescription Statin Medication" (2024). Faculty, Staff and Students Publications. 6719.
https://digitalcommons.library.tmc.edu/baylor_docs/6719