Martin Wawruch1, Gejza Wimmer2, Jan Murin3, Martina Paduchova4, Tomas Tesar5, Lubica Hlinkova6,7, Peter Slavkovsky8, Emma Aarnio9,10. 1. Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08, Bratislava, Slovakia. martin.wawruch@gmail.com. 2. Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia. 3. 1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia. 4. Department of Angiology, Health Centre, Trnava, Slovakia. 5. Department of Organization and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Odbojarov 10, 832 32, Bratislava, Slovakia. tesar@fpharm.uniba.sk. 6. General Health Insurance Company, Bratislava, Slovakia. 7. Institute for Healthcare Disciplines, St. Elizabeth College of Health and Social Work, Bratislava, Slovakia. 8. Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia. 9. Institute of Biomedicine, University of Turku, Turku, Finland. 10. School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Abstract
BACKGROUND: Long-term persistence represents a basic precondition of successful statin treatment in patients with peripheral arterial disease (PAD). OBJECTIVES: The aims of our study were evaluation of reinitiation in older PAD patients who were non-persistent with statin treatment, and identification of patient-related characteristics associated with the patient's probability of reinitiation. METHODS: Our study cohort included 2977 older patients (≥ 65 years) who were non-persistent with statin treatment in whom PAD was newly diagnosed in 2012. Reinitiation was defined as the first statin prescription recorded after discontinuation. To analyze factors associated with the patient´s probability of reinitiation, Cox regression with time-dependent covariates was applied. RESULTS: After post-discontinuation follow-up of a mean of 27 months, reinitiation of statin treatment was recorded for 1244 (41.8%) patients. Increasing age, Parkinson's disease, being a new statin user (patient in whom statin treatment was initiated in association with PAD diagnosis), general practitioner as the index prescriber who prescribed a statin for the first time after diagnosis of PAD, coadministration of loop diuretics, and longer persistence before discontinuation decreased the patient's likelihood of reinitiation, whereas myocardial infarction during non-persistence, high-intensity statin treatment, and increasing number of medications increased the patient's probability of reinitiation. CONCLUSIONS: In patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed.
BACKGROUND: Long-term persistence represents a basic precondition of successful statin treatment in patients with peripheral arterial disease (PAD). OBJECTIVES: The aims of our study were evaluation of reinitiation in older PAD patients who were non-persistent with statin treatment, and identification of patient-related characteristics associated with the patient's probability of reinitiation. METHODS: Our study cohort included 2977 older patients (≥ 65 years) who were non-persistent with statin treatment in whom PAD was newly diagnosed in 2012. Reinitiation was defined as the first statin prescription recorded after discontinuation. To analyze factors associated with the patient´s probability of reinitiation, Cox regression with time-dependent covariates was applied. RESULTS: After post-discontinuation follow-up of a mean of 27 months, reinitiation of statin treatment was recorded for 1244 (41.8%) patients. Increasing age, Parkinson's disease, being a new statin user (patient in whom statin treatment was initiated in association with PAD diagnosis), general practitioner as the index prescriber who prescribed a statin for the first time after diagnosis of PAD, coadministration of loop diuretics, and longer persistence before discontinuation decreased the patient's likelihood of reinitiation, whereas myocardial infarction during non-persistence, high-intensity statin treatment, and increasing number of medications increased the patient's probability of reinitiation. CONCLUSIONS: In patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed.
Authors: Michal Tendera; Victor Aboyans; Marie-Louise Bartelink; Iris Baumgartner; Denis Clément; Jean-Philippe Collet; Alberto Cremonesi; Marco De Carlo; Raimund Erbel; F Gerry R Fowkes; Magda Heras; Serge Kownator; Erich Minar; Jan Ostergren; Don Poldermans; Vincent Riambau; Marco Roffi; Joachim Röther; Horst Sievert; Marc van Sambeek; Thomas Zeller Journal: Eur Heart J Date: 2011-08-26 Impact factor: 29.983
Authors: Scott M Grundy; Neil J Stone; Alison L Bailey; Craig Beam; Kim K Birtcher; Roger S Blumenthal; Lynne T Braun; Sarah de Ferranti; Joseph Faiella-Tommasino; Daniel E Forman; Ronald Goldberg; Paul A Heidenreich; Mark A Hlatky; Daniel W Jones; Donald Lloyd-Jones; Nuria Lopez-Pajares; Chiadi E Ndumele; Carl E Orringer; Carmen A Peralta; Joseph J Saseen; Sidney C Smith; Laurence Sperling; Salim S Virani; Joseph Yeboah Journal: Circulation Date: 2018-11-10 Impact factor: 29.690