Understanding Patient Adherence and Concerns with STatins and MedicatION Discussions With Physicians (ACTION): A survey on the patient perspective of dialogue with healthcare providers regarding statin therapy.

Abstract

Statins are first-line for cholesterol lowering and prevention of atherosclerotic cardiovascular disease (ASCVD), but their use is complicated by side effects and potential for drug-drug interactions. Provider-patient communication is the basis of the recommended shared decision-making, but relatively little is known about this in the context of statin use. We surveyed 5014 US adults prescribed a statin for hypercholesterolemia to learn their perspectives on communication with their provider. Ninety-four percent reported currently taking a statin while 6% had stopped. Past users vs current users were more likely to be female, age < 65 years, and to have fewer cardiovascular disease-related comorbidities (hypertension, type 2 diabetes mellitus, and coronary heart disease, respectively). Although 93% of current statin users were taking ≥1 other prescription medications (median of 4), 76% were "not at all"/"not very concerned" about potential drug-drug interactions with their statin, and fewer than one-quarter recalled mention of these from their provider. Ninety-five percent of subjects said it was "extremely"/"somewhat" important that their healthcare provider take "an individualized approach to selecting the right statin," but 73% and 76%, respectively, said their statin choice was made with little or no input from them. Only 25% were told that "some statins might be more likely than others to interact with other medications," and only 18% (and only 20% of past users) were told that "their particular statin might interact with other medications." Provider-patient communication regarding statin therapy appears inadequate, by patient recall, and efforts to improve it are warranted.