Abstract
BackgroundWhile the factors for poor adherence for treatment with statins have been highlighted, the impact of their combination on adherence is not clear.AimsTo estimate adherence for statins and whether it differs according to the number of cardiovascular risk factors.MethodsA cohort study was conducted using data from the main French national health insurance system reimbursement database. Newly treated patients with statins between September 1 and December 31, 2004 were included. Patients were followed up 15 months. The cohort was split into three groups according to their number of additional cardiovascular risk factors that included age and gender, diabetes mellitus and cardiovascular disease (using co-medications as a proxy). Adherence was assessed for each group by using four parameters: (i) proportion of days covered by statins, (ii) regularity of the treatment over time, (iii) persistence, and (iv) the refill delay.Results16,397 newly treated patients were identified. Of these statin users, 21.7% did not have additional cardiovascular risk factors. Thirty-one percent had two cardiovascular risk factors and 47% had at least three risk factors. All the parameters showed a sub-optimal adherence whatever the group: days covered ranged from 56% to 72%, regularity ranged from 23% to 33% and persistence ranged from 44% to 59%, but adherence was better for those with a higher number of cardiovascular risk factors.ConclusionsThe results confirm that long-term drug treatments are a difficult challenge, particularly in patients at lower risk and invite to the development of therapeutic education.
Highlights
While the factors for poor adherence for treatment with statins have been highlighted, the impact of their combination on adherence is not clear
The aim of this study was to estimate whether adherence differs according to the number of cardiovascular risk factors
The refund rate is 100% for patients with insufficient income and for patients suffering from permanent serious disease such as myocardial infarction. This database has been previously described [25]. Data extracted from this database were demographic characteristics of the users, prescribers’ specialty, the name of drugs submitted for reimbursement and vital status
Summary
While the factors for poor adherence for treatment with statins have been highlighted, the impact of their combination on adherence is not clear. Statins are by far the principal class used for hypercholesterolemia and their efficacy in reducing the occurrence of cardiovascular adverse clinical outcomes has been clearly documented during the last two decades [1,2,3,4,5,6,7,8,9,10,11] The impact of this class on the whole drug reimbursement cost has regularly and absence of cardiovascular morbidity, women, number of coprescribed drugs [15,16,17,18,19,20,21,22,23,24]. The aim of this study was to estimate whether adherence differs according to the number of cardiovascular risk factors
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