Effects of the 2013 American College of Cardiology/American Heart Association guidelines on racial and ethnic disparities in statin treatment among diabetics

Background: Significant racial and ethnic disparities in statin prescribing and utilization have been constantly documented. Objective: To examine whether racial/ethnic disparities in statin treatment have decreased among the diabetic population after the release of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Methods: This retrospective study analyzed patients with diabetes aged 40–75 years old in the Medicare Expenditure Panel Survey (2011-2012 and 2014–2015). Racial and ethnic disparities in the likelihood of statin use and number of statin prescriptions were compared before and after the guideline release. Logistic and negative binomial regressions were used to adjust for patient characteristics. A difference-in-difference model (DID) was used to examine disparity changes. Results: This study included 2584 patients from 2011 to 2012 and 2610 from 2014 to 2015. During 2011–2012, racial/ethnic disparities were significant for the likelihood of statin use. For the number of statin prescriptions, racial disparity was significant, but not for the ethnic disparity. During 2014–2015, racial/ethnic disparities were significant for the likelihood of statin use but were not significant for the number of statin prescriptions. The DID model found that the 2013 guidelines were not associated with a reduction in racial and ethnic disparities in statin treatment. Conclusions: This study found persistent disparities in the likelihood of statin use. The 2013 ACC/AHA guidelines were not associated with a reduction in racial and ethnic disparities in statin treatment.