PURPOSE: Statins are potent drugs for reducing cholesterol and cardiovascular disease; however, their effectiveness is significantly compromised by poor adherence. This prospective study was designed to identify potentially modifiable patient factors including medication, disease, and diet beliefs related to statin adherence. METHODS: Veterans (n = 71) given their first prescription of a statin for primary prevention were interviewed at baseline, 3 months, and 6 months regarding medication, disease, and diet beliefs along with self-reported statin adherence. RESULTS: At 6-month follow-up, 55% of the cohort was non-adherent with 10% reporting never having started their statin, 50% reporting misconceptions about the duration of treatment and a median use of <2 months among those who discontinued their statin. Multivariate predictors of non-adherence were expected short treatment duration (OR = 3.6, 1.4-9.4), low perceived risk of myocardial infarction (OR = 3.1, 1.1-8.7), concern about potential harm from statins (OR = 2.5, 1.0-6.3), being Hispanic (OR = 3.9, 1.0-15.2), and younger age (OR = 4.2, 1.1-15.8). CONCLUSIONS: Poor adherence to statins was common in this primary prevention population with frequent early discontinuation despite access to low-cost medicines. Patient factors regarding the perception of risk, toxic effects of medication, expected treatment duration, as well as socio-demographic factors, were significant predictors of poor adherence and warrant further exploration.
PURPOSE: Statins are potent drugs for reducing cholesterol and cardiovascular disease; however, their effectiveness is significantly compromised by poor adherence. This prospective study was designed to identify potentially modifiable patient factors including medication, disease, and diet beliefs related to statin adherence. METHODS: Veterans (n = 71) given their first prescription of a statin for primary prevention were interviewed at baseline, 3 months, and 6 months regarding medication, disease, and diet beliefs along with self-reported statin adherence. RESULTS: At 6-month follow-up, 55% of the cohort was non-adherent with 10% reporting never having started their statin, 50% reporting misconceptions about the duration of treatment and a median use of <2 months among those who discontinued their statin. Multivariate predictors of non-adherence were expected short treatment duration (OR = 3.6, 1.4-9.4), low perceived risk of myocardial infarction (OR = 3.1, 1.1-8.7), concern about potential harm from statins (OR = 2.5, 1.0-6.3), being Hispanic (OR = 3.9, 1.0-15.2), and younger age (OR = 4.2, 1.1-15.8). CONCLUSIONS: Poor adherence to statins was common in this primary prevention population with frequent early discontinuation despite access to low-cost medicines. Patient factors regarding the perception of risk, toxic effects of medication, expected treatment duration, as well as socio-demographic factors, were significant predictors of poor adherence and warrant further exploration.
Authors: Paul Muntner; Suzanne E Judd; Marie Krousel-Wood; William M McClellan; Monika M Safford Journal: Am J Kidney Dis Date: 2010-05-14 Impact factor: 8.860
Authors: Alexander Chaitoff; Michael B Rothberg; Amy K Windover; Leonard Calabrese; Anita D Misra-Hebert; Kathryn A Martinez Journal: J Gen Intern Med Date: 2018-11-07 Impact factor: 5.128
Authors: Devin M Mann; Nicole L Glazer; Michael Winter; Michael K Paasche-Orlow; Paul Muntner; Daichi Shimbo; William G Adams; Nancy R Kressin; Yuqing Zhang; Hyon Choi; Howard Cabral Journal: Am J Cardiol Date: 2013-02-20 Impact factor: 2.778