A novel web-based application designed to qualify patients with high low-density lipoprotein (LDL) cholesterol for treatment with nonprescription statins may be comparable to physician assessment.

Less than 50% of patients who are eligible for treatment with statins are currently receiving the drugs.

In the TACTIC trial, results of which were presented by Nissen et al at the American College of Cardiology (ACC) Annual Scientific Session 2024 and simultaneously published in the Journal of the American College of Cardiology, researchers developed the web-based application on the basis of eligibility criteria and asked 1,196 participants to undergo medical assessment using the technology. Participants entered information such as their demographics, drug use, medical history, and cholesterol and blood pressure levels, and were then were informed of their statin use eligibility via three possible outcomes from the application: “Do Not Use,” “Ok to Use,” or “Ask a Doctor.” Following the assessment using the web-based application, the participants were then evaluated by physicians to determine their eligibility for statin use. Only the patients who were deemed eligible for statins were allowed to create an account to purchase up to a 90-day supply of 5 mg daily rosuvastatin. The patients were also required to complete another web-based assessment to qualify for a second 90-day supply of rosuvastatin and underwent physician assessment after the study period.

Concordance between the web-based application and physician assessment was 90.7% at baseline and 98.1% at final assessment. After a follow-up of about 6 months, the participants prescribed 5 mg of rosuvastatin experienced a 35.5% reduction in their LDL cholesterol levels.

The findings indicated that the technology-assisted approach may improve access to statins without physician qualification and prescription.

“Not only did participants self-select correctly, they also demonstrated they could appropriately self-administer the drug and they obtained a reduction in LDL cholesterol. We think this approach can make statins available to more [patients] who are not currently taking these important drugs,” concluded lead study author Steven E. Nissen, MD, Chief Academic Officer at the Heart, Vascular, and Thoracic Institute at the Cleveland Clinic.