Continuity of care cuts ASCVD risk in newly diagnosed dyslipidaemic patients

Good continuity of care (COC) helps prevent atherosclerotic cardiovascular disease (ASCVD) in patients with newly diagnosed dyslipidaemia, a recent Korea study has found.

Researchers conducted a retrospective cohort study of 236,486 patients who received their first diagnosis of dyslipidaemia in 2008. COC was quantified using the Bice-Boxerman Continuity of Care Index. In the absence of established standards, the researchers set an Index score ≥0.8 to denote high continuity and <0.8 as low continuity. Participants were divided into two groups accordingly.

More than half (53 percent; n=127,238) of the participants were deemed to have high COC and were significantly younger than their low COC counterparts (p<0.001). Similarly, they were more likely to have concomitant diabetes mellitus but were less likely to be on antihyperlipidaemic agents. Over time, the researchers recorded a consistent decrease in Index score, particularly in the high COC subgroup.

Cox proportional hazards regression analysis revealed that the risk of ASCVD was significantly elevated in the low vs high COC group (adjusted hazard ratio [HR], 1.09, 95 percent confidence interval [CI], 1.06–1.12; p<0.001). A similar and stronger effect was obtained when using a time-dependent model (adjusted HR, 1.27, 95 percent CI, 1.23–1.31; p<0.001).

As a result, measures of ASCVD-related healthcare utilization were higher among those with low COC, including the number of patients hospitalized and number of patients visiting the emergency department, as well as both public and out-of-pocket expenditures (p<0.001 for all)

“Efforts should be made to ensure that doctors and patients are aware of the good impact of COC,” the researchers said. “In this regard, qualitative study investigating the perceptions of professionals or patients on COC will be helpful to disclose their awareness and views of it.”