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Question: STK-6 Reason for Not Prescribing a Statin Medication at Discharge

Is LDL no longer important? Does every stroke patient need a prescription for a statin at discharge or a documented reason? Does the statin prescribed need to be a high intensity dosage to pass the measure?

Answer:

There is less emphasis on LDL target value in the revised ACC/AHA Guidelines for the Management of Blood Cholesterol in Adults (Stone, et al, 2013. Patients who experience an ischemic stroke should be prescribed a statin at discharge for secondary stroke prevention. If a statin is not prescribed at discharge, then a documented reason is needed to exclude the case. Documentation of a LDL less than 70 (69 or below) any time during the hospital stay or within 30 days prior to hospital arrival is a stand-alone Reason for Not Prescribing Statin at Discharge. No further reason documentation is needed to exclude the case if there is documentation of LDL less than 70 in the medical record.

The revised guidelines also recommend high intensity statin therapy for ischemic stroke patients less than 75 years of age; however, statin dosage is not used to calculate the STK-6 measure rate.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, STK 6
Manual: Current Manual (current data collection period; prior to data transmission)
File:

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