A familiar clinic visit for most internists, family practitioners, and cardiologists is the discussion about statin side effects. While some have been debunked, myopathy remains a challenging issue. What makes it tough is teasing out real statin-related myopathy from the plethora of other things that can cause aches & pains.
This tool from the ACC aims to address the issue of statin intolerance, specifically statin myopathy.
The app opens to a home screen with three options: Evaluate, Follow-Up, and Compare.
The Evaluate section walks through a “risk calculator” of the major considerations when evaluating someone with potential statin-related myopathy like the type of pain, relationship to statin initiation, risk factors such as other medications & age, and lab abnormalities. There is a list of labs you could consider ordering though more guidance on there on which ones should be ordered when would be helpful.
I expected some sort of risk score or qualitative assessment (e.g. low, medium, high) based on the design but what you get is basically a chart saying which parts of the history go for or against statin myopathy. There’s no specific guidance or suggestion about what to do next other than saying it’s a risk/benefit decision.
Things missing here were recommendations on follow-up timing. Also not discussed really is lab testing in follow up.
Some notable features that were missing here were shareable patient information on statin side-effects (real and bogus) and a side-by-side drug comparison option.
Overall, the app contains a fair amount of practical and useful information; also included are links to a wide range of lipid-related resources. As an in-clinic resource, I found it to be a bit too cumbersome to use regularly as a decision support tool. It is however a great educational tool, if used periodically or even just read outside of clinic visits, on how to perform the evaluation for statin myopathy and manage these patients subsequently.
- Practical information and guidance, especially in follow up of patients with potential statin intolerance
- Nice overview of risk factors and interacting medications
- Good decision tree for follow up of these patients in terms of rechallenging, dose adjustments, and medication changes.
- Reputable information source
- Design is a bit cumbersome, making use challenging during a clinic visit (just takes a long time)
- After putting in all that information on symptoms and risk factors, no recommendation is made on what to do (basically says talk to the patient and decide)
- Follow up lacks specifics on lab testing and follow-up intervals
The Statin Intolerance app is a good resource for learning the questions to ask & factors to consider when evaluating patients for potential statin myopathy. The advice on follow up does walk through a nice decision tree as well, but could be improved with specifics on lab testing and follow-up intervals. Design elements could certainly be better. Nonetheless, for clinicians that deal with this issue infrequently or just want to learn more about management strategies, this app is a great free resource.
- Overall Score
- User Interface
Decision tree & calculator designs could be more user friendly
- Multimedia Usage
Visual appeal of design could be improved; also would benefit from patient education material
Can’t beat free!
- Real World Applicability
Practical advice for a frequently arising clinical issue
- Device Used For Review
- Available for DownloadAndroidiPhone