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Kenneth L. Brier, RPh, MS; John J. Tornow, MD, MBA; Andrea J. Ries, PharmD, BCPS; Mary P. Weber, RPh, MS, BCPS; John R. Downs, MD

Arch Intern Med. 1999;159:569-575.

Background  To forecast adult patient outcomes in the management of hyperlipidemia using adult National Health and Examination Survey III (NHANES III) population statistics and National Cholesterol Education Program (NCEP) guidelines for goals of therapy.

Methods  Review of the hyperlipidemia drug therapy English-language medical literature with emphasis on randomized controlled trials of more than 6 weeks' duration published in the last 7 years, product package inserts, US Food and Drug Administration submission information, and NHANES III population statistics. Data were extracted from studies of lipid-lowering therapy to modify low-density lipoprotein (LDL) levels for primary and secondary prevention of coronary heart disease. The data that were evaluated included sample size, study design, therapeutic intervention, length of study, percentage change in LDL levels, and patient demographics.

Results  Cumulative frequency curves of the LDL distribution among the US adult population were constructed. The mean efficacy of drug therapy from qualified studies was used to extrapolate the percentage of the population expected to respond to the intervention and to forecast the patient outcome.

Conclusions  A useful tool for clinicians was constructed to approximate the percentage of patients, based on risk stratification, who would reach NCEP target goal after a given pharmacotherapeutic intervention to decrease LDL levels.

From Micromedex, Inc, Englewood, Colo (Mr Brier); Foundation Health Federal Services, Inc, Austin, Tex (Dr Tornow); and the Department of Defense Pharmacoeconomic Center, Fort Sam Houston, Tex (Drs Ries and Downs and Ms Weber). Dr Ries is now with the Trinity Valley Medical Center, Palestine, Tex, and Ms Weber is with the Naval Ambulatory Care Center, Groton, Conn.

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