Abstract
We sought to identify specific profiles of new lipid-lowering drug users based on adherence to a healthy lifestyle and persistence with medication, and to characterize co-morbidities, co-treatments, and healthcare utilization for each of the profiles identified. Observational study in 517 participants in the Aragon Workers’ Health Study (AWHS) without previous cardiovascular disease (CVD) and who initiated lipid-lowering therapy. Data were collected from workplace medical examinations and administrative health databases (2010–2018). Using cluster analysis, we identified distinct patient profiles based on persistence with therapy and lifestyle. We then compared characteristics, morbidity, and healthcare utilization across clusters. Participants were aggregated into four clusters based on persistence with therapy, smoking status, adherence to Mediterranean diet, and physical activity. In cluster 1 (n = 113), comprising those with a healthiest lifestyle (14.2% smokers, 84.0% with medium-high adherence to Mediterranean diet, high physical activity), 16.8% were persistent. In cluster 3 (n = 108), comprising patients with the least healthy lifestyle (100% smokers, poor adherence to the Mediterranean diet, low level of physical activity), all were non-persistent. Clusters 2 (n = 150) and 4 (n = 146) both comprised patients with intermediate lifestyle behaviors, but differed in terms of persistence (100 and 0%, respectively). Compared with other clusters, the burden of morbidity, cardiovascular score, and healthcare utilization were lower in cluster 1. The healthy adherer effect was only observed in new lipid-lowering drug users of certain profiles. Furthermore, we found that differences in adherence to lifestyle and medication recommendations for CVD prevention influenced morbidity burden and healthcare utilization.
Highlights
Cardiovascular disease (CVD) is the leading cause of death in Europe [1]
Evidence indicates that adherence to drug therapy does not necessarily imply general healthy behaviour [9,10,11]. These conflicting findings suggest that an association between healthy lifestyle and good adherence to prescribed therapies is only found in individuals with certain profiles, the characterization of which may be beneficial for cardiovascular disease (CVD) management
The Aragon Workers’ Health Study (AWHS) is a prospective longitudinal study aimed at evaluating the association between CVD risk factors and metabolic abnormalities and subclinical atherosclerosis in a middle-aged working population in Spain that was CVD-free at the beginning of the study
Summary
Cardiovascular disease (CVD) is the leading cause of death in Europe [1]. Individual control of CVD risk factors is based on health-promoting behaviors, consisting primarily of smoking cessation, a healthy diet, regular exercise, weight control, and reduced stress.When lifestyle changes are insufficient, it is advisable to establish evidence-based preven- 4.0/).tive therapy [2]. The “healthy adherer effect”, whereby individuals who adhere to medication tend to adhere to healthy lifestyle behaviors, and have a better health status, is well described [6] This effect is considered a common source of bias in observational studies [7]. Evidence indicates that adherence to drug therapy does not necessarily imply general healthy behaviour [9,10,11]. These conflicting findings suggest that an association between healthy lifestyle and good adherence to prescribed therapies is only found in individuals with certain profiles, the characterization of which may be beneficial for CVD management
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
