A technology-assisted Web application for consumer self-selection of nonprescription rosuvastatin 5 mg showed 96.2% concordance (95% CI: 94.1%-97.7%) with independent clinician assessment.
Cross-Sectional (n=500)
Single-blind
Does an at-home Web-based application improve concordance of self-selected eligibility for nonprescription rosuvastatin with clinician assessment in general participants?
A technology-assisted approach for consumer self-selection of nonprescription statin therapy demonstrated 96.2% concordance with clinician assessment, suggesting it may be a viable tool for expanding access.
BACKGROUND: Although statins reduce cardiovascular morbidity and mortality, only about one-half of eligible patients receive treatment. Safe and appropriate consumer access to statins could have a significant positive public health impact. OBJECTIVES: This study compares the concordance between a participant and clinician assessment of eligibility for statin therapy using a technology-assisted approach. METHODS: A total of 500 participants, 83 with limited literacy, completed an at-home Web-based application to assess appropriateness for treatment with rosuvastatin 5 mg. The Web application is designed to assess eligibility for a moderate-intensity statin based on current guidelines and deny access to individuals with contraindications to rosuvastatin. Subsequently, participants visited a research site where clinicians, blinded to the information the participant entered, performed an independent Web application assessment. The Web application is programmed for 1 of 3 rosuvastatin treatment outcomes: "OK to use," "not right for you," or "ask a doctor." The primary endpoint was the percent of participants whose self-selected eligibility for nonprescription rosuvastatin was concordant with clinician assessment. RESULTS: For the primary endpoint, participant selection for statin therapy was concordant with clinician selection in 481 (96.2%) of 500 participants (95% confidence interval: 94.1%-97.7%), of whom 23 (4.6%) were deemed appropriate and 458 (91.6%) were deemed inappropriate for treatment. Discordance was due to incorrect self-selection ("OK to use") in 3 cases, incorrect rejection ("not right for you") in 14 cases and an incorrect "ask a doctor" outcome in 2 cases. CONCLUSIONS: The use of a technology-assisted approach to consumer self-selection for statin therapy resulted in participant self-selection that showed substantial agreement with clinician selection.
Nissen et al. (2021) conducted a cross-sectional in Eligibility for statin therapy (n=500). Technology-assisted Web-based application for self-selection vs. Clinician assessment was evaluated on Percent of participants whose self-selected eligibility for nonprescription rosuvastatin was concordant with clinician assessment (95% CI 94.1%-97.7%). A technology-assisted Web application for consumer self-selection of nonprescription rosuvastatin 5 mg showed 96.2% concordance (95% CI: 94.1%-97.7%) with independent clinician assessment.