Hyperlipidemia Pharmacotherapy in Skilled Nursing Facilities: A Real-World Evidence Study

Objectives: To estimate hyperlipidemia medication order prevalence and associated variables in U.S. skilled nursing facility (SNF) residents. Design: Retrospective, observational study. Setting and Participants: Electronic Health Record data from 447,080 SNF residents with a hyperlipidemia diagnosis identified in PointClickCare's Life Sciences clinical database (January-April 2025) were reviewed. Methods: The presence and absence of medication orders for hyperlipidemia treatments recommended by the American Heart Association were assessed. Descriptive analyses summarized demographic and clinical characteristics, and a modified Poisson regression model was used to estimate risk ratios for having a medication order, adjusting for demographic, clinical, and facility characteristics. Results: Overall, 83.3% of residents diagnosed with hyperlipidemia had at least one hyperlipidemia medication order. Statins were ordered by 96.2% of active order residents, while other medication classes i.e., omega-3 fatty acids, cholesterol absorption inhibitors, fibrates were less common (<8%). Risk ratios (RRs) for medication orders ranged from 0.87-1.16. Factors most strongly associated with having an order included hypertension medication orders (RR=1.16), unspecified hyperlipidemia diagnosis (RR=1.10), and active diabetes medication orders (RR=1.09); female sex (RR=0.95) and private (0.94) or other (0.87) payer types were associated with a lower likelihood of having an order. Conclusions and Implications: Most residents with a hyperlipidemia diagnosis had an active relevant medication order, but use of non-statin therapies was rare. Differences in treatment patterns by sex and payer type, along with limited uptake of newer agents, warrant further investigation into prescribing practices and access within SNFs.