Venipuncture Rate of Liver Function Tests for Patients being Treatment with Statin in Clinical Practice: A Therapeutic Dilemma

Abstract

Background: Statin or 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors are hypolipidemic agent. Its main functionality is to reduce cholesterol. The low-density lipoprotein cholesterol is the major cause of myocardial infarction. The adverse effect of this medication is hepatotoxicity. Doctors always request patient on statin treatment to obtain blood by venipuncture for liver function tests (LFTs) frequently. There are no researches studying the rate and expenditure of venipuncture for LFTs in patients being treated with statin.Objective: To study unnecessary rate on venipuncture for LFTs in patients being treatment with statin at an outpatient clinic.Material and Method: Retrospective cohort study. Data are collected from medical records that being treatment with statin at an outpatient clinic, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University between March 1, 2012 and March 1, 2014. The 441 patients are divided into two groups. The first group is treated with the appropriate venipuncture for LFTs and the second group is treated with unnecessary venipuncture for LFTs. The expenditure for both groups are used to calculate and compare costs.Results: The number of unnecessary venipuncture in the LFTs group is 308 samples (69.84%). The sample proportions are 85.06% come from staff (262 samples) and 14.94% come from interns (46 samples). The number of appropriate venipuncture for LFTs is 133 samples (30.16%). The sample proportions are 77.44% come from staff (103 samples) and 22.56% come from interns (30 samples). The expenditure of the unnecessary venipuncture for LFTs had a statistically significant difference from the appropriate venipuncture for LFTs [75,500 vs. 4,400 baht (THB)] (p<0.05).Conclusion: The expenditure for the unnecessary venipuncture LFTs in patient being treated with statin at the outpatient clinic is statistically higher than the appropriate venipuncture (p<0.05).