Beyond Statins: How Pharmacists Can Help Patients Understand All Their Cholesterol Treatment Options

In an interview with Pharmacy Times, Laxmi Mehta, MD, professor in the Division of Cardiovascular Medicine and director of the Lipid Clinics at The Ohio State University Wexner Medical Center, discussed findings from a recent survey revealing that 61% of respondents were unaware that nonstatin cholesterol medications exist—and what the pharmacy community can do to change that.

Mehta attributed this awareness gap to 2 primary factors: a knowledge deficit at the provider level and significant access barriers for patients. Although statins remain the cornerstone of pharmacologic lipid management, newer agents have emerged over the past decade that many clinicians and patients alike have not had the opportunity to learn about. When cost and access issues compound that knowledge gap, even informed providers face difficulty getting appropriate therapies to the patients who need them.

On the subject of statin misconceptions, Mehta outlined several she frequently encounters in her lipid clinic. Patients commonly believe statins do not work, that their cholesterol levels are already "fine," or that adverse effects are inevitable. She emphasized that although some patients do experience muscle-related symptoms ranging from mild to severe, the majority tolerate statins well. She also addressed concerns around diabetes risk, noting the association is largely limited to patients with preexisting diabetic risk factors, and pushed back firmly on the notion that statins cause dementia, citing extensive randomized controlled trials and systematic reviews that have found no definitive link, with some smaller studies even suggesting a protective effect.^1,2

Regarding pharmacy practice, Mehta highlighted the value of pharmacists, particularly those who are lipid-certified, in comanaging patients, discussing low-density lipoprotein targets, and identifying nonadherence that patients may not disclose to their physicians. She noted that patients often trust their local pharmacists deeply, making those interactions a vital touchpoint for education, and stressed that when pharmacists spot hesitancy around a prescription, proactive communication with the prescribing team is essential to keeping patients on the path to optimal cardiovascular care.

REFERENCES

1. Zhou Z, Ryan J, Ernst ME, et al; ASPREE Investigator Group. Effect of statin therapy on cognitive decline and incident dementia in older adults. J Am Coll Cardiol. 2021;77(25):3145-3156. doi:10.1016/j.jacc.2021.04.075

2. Westphal Filho FL, Moss Lopes PR, Menegaz de Almeida A, et al. Statin use and dementia risk: a systematic review and updated meta-analysis. Alzheimers Dement (N Y). 2025;11(1):e70039. doi:10.1002/trc2.70039