Richard Ofori-Asenso1,2,3, Jenni Ilomäki4,5, Mark Tacey1, Ella Zomer1, Andrea J Curtis3, J Simon Bell4,5,6, Sophia Zoungas3, Danny Liew1. 1. Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 2. Epidemiological Modelling Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 3. Division of Metabolism, Ageing and Genomics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 4. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia. 5. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 6. School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Statins reduce the risk of cardiovascular disease in patients with diabetes. This study examined the prevalence of statin use and assessed long-term adherence and persistence among people aged ≥65 years with diabetes. METHODS: Pharmaceutical Benefits Scheme data covering a 10% random sample of the Australian population were analyzed. Among older adults with diabetes, the yearly prevalence of statin use was compared via Poisson regression modeling using 2006 as the reference year. A cohort of 7400 new statin users (mean age 72.9 years; 46.2% female) was followed longitudinally. Adherence was assessed via the proportion of days covered (PDC). Statin discontinuation was defined as the first ≥90 days without statin coverage. RESULTS: The prevalence of statin use increased from 52.0% in 2006 to 71.2% in 2016 (age and sex-adjusted rate ratio 1.37; 95% confidence interval 1.33-1.41). No gender differences in statin use were observed, but the likelihood of being dispensed statin decreased with increasing age. Among the longitudinal cohort, the proportion adherent (PDC ≥0.80) decreased from 54.0% at 6 months to 37.0% at 9 years. Over a mean follow-up of 4.9 years, 66.8% discontinued, and the likelihood of stopping statin medication within the first year was 42.7%. No age or gender differences in statin discontinuation were evident. CONCLUSIONS: Statin use has increased among older adults with diabetes. However, adherence is low and discontinuation is high. Further investigations into the factors associated with non-adherence or discontinuation of statins are important so as to optimize statin use towards achieving the intended cardiovascular benefits among older people with diabetes.
BACKGROUND: Statins reduce the risk of cardiovascular disease in patients with diabetes. This study examined the prevalence of statin use and assessed long-term adherence and persistence among people aged ≥65 years with diabetes. METHODS: Pharmaceutical Benefits Scheme data covering a 10% random sample of the Australian population were analyzed. Among older adults with diabetes, the yearly prevalence of statin use was compared via Poisson regression modeling using 2006 as the reference year. A cohort of 7400 new statin users (mean age 72.9 years; 46.2% female) was followed longitudinally. Adherence was assessed via the proportion of days covered (PDC). Statin discontinuation was defined as the first ≥90 days without statin coverage. RESULTS: The prevalence of statin use increased from 52.0% in 2006 to 71.2% in 2016 (age and sex-adjusted rate ratio 1.37; 95% confidence interval 1.33-1.41). No gender differences in statin use were observed, but the likelihood of being dispensed statin decreased with increasing age. Among the longitudinal cohort, the proportion adherent (PDC ≥0.80) decreased from 54.0% at 6 months to 37.0% at 9 years. Over a mean follow-up of 4.9 years, 66.8% discontinued, and the likelihood of stopping statin medication within the first year was 42.7%. No age or gender differences in statin discontinuation were evident. CONCLUSIONS: Statin use has increased among older adults with diabetes. However, adherence is low and discontinuation is high. Further investigations into the factors associated with non-adherence or discontinuation of statins are important so as to optimize statin use towards achieving the intended cardiovascular benefits among older people with diabetes.
Authors: Richard Ofori-Asenso; Jenni Ilomäki; Mark Tacey; Si Si; Andrea J Curtis; Ella Zomer; J Simon Bell; Sophia Zoungas; Danny Liew Journal: Br J Clin Pharmacol Date: 2018-11-08 Impact factor: 4.335
Authors: Karen Ho; Kris M Jamsen; J Simon Bell; Maarit Jaana Korhonen; Kevin P Mc Namara; Dianna J Magliano; Danny Liew; Taliesin E Ryan-Atwood; Jonathan E Shaw; Susan Luc; Jenni Ilomäki Journal: Eur J Clin Pharmacol Date: 2018-07-19 Impact factor: 2.953
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Authors: Ken Lee Chin; Richard Ofori-Asenso; Si Si; Thomas R Hird; Dianna J Magliano; Sophia Zoungas; Danny Liew Journal: Sci Rep Date: 2019-03-01 Impact factor: 4.379
Authors: Helena Ödesjö; Staffan Björck; Stefan Franzén; Per Hjerpe; Karin Manhem; Annika Rosengren; Jörgen Thorn; Samuel Adamsson Eryd Journal: BMJ Open Date: 2020-10-10 Impact factor: 2.692
Authors: Stella Talic; Clara Marquina; Richard Ofori-Asenso; Marjana Petrova; Danny Liew; Alice J Owen; Sean Lybrand; David Thomson; Jenni Ilomaki; Ella Zomer; Zanfina Ademi Journal: Cardiovasc Drugs Ther Date: 2021-06-07 Impact factor: 3.947