Community pharmacist intervention to optimize statin adherence in diabetes care: The GuIDE-S study

Abstract

BackgroundStatin use in people with type 2 diabetes (T2D) reduces cardiovascular events, yet adherence remains suboptimal. ObjectiveThis study evaluated the impact of a community pharmacist intervention on statin adherence in new users with T2D. MethodsAs part of a quasi-experimental study, community pharmacy staff proactively identified adult patients with T2D who were not prescribed a statin. When appropriate, the pharmacist prescribed a statin via a collaborative practice agreement or facilitated acquisition of a prescription from another prescriber. Patients received individualized education and follow-up and monitoring for 1 year. Adherence was defined as the proportion of days covered (PDC) by a statin over 12 months. Linear and logistic regression were used to compare the effect of the intervention on continuous and a binary adherence threshold, defined as PDC ≥ 80%, respectively. ResultsOverall, 185 patients started statin therapy and were matched to 370 control patients for analysis. Adjusted average PDC was 3.1% higher in the intervention group (95% CI −0.037 to 0.098). Patients in the intervention group were 21.2% more likely to have PDC ≥ 80% (95% CI 0.828–1.774). ConclusionThe intervention resulted in higher statin adherence than usual care; however, the differences were not statistically significant.