Adherence with statins in a real-life setting is better when associated cardiovascular risk factors increase: a cohort study

BMC Cardiovascular Disorders

Research Article

Philippe Latry¹  Bernard Dedieu¹  Thierry Couffinhal²  Bernard Bégaud³  Mathieu Molimard³  Karin Martin-Latry⁴ 

[1] Direction Régionale du Service Médical de l'Assurance Maladie d'Aquitaine, Cnam-TS, (33000), Bordeaux, France;Univ. de Bordeaux, (33000), Bordeaux, France;Centre d'exploration, de prévention et de traitement de l'athérosclérose, hôpital Haut-Lévêque, (33600), Pessac, France;U 1034, INSERM, (33600), Pessac, France;Univ. de Bordeaux, (33000), Bordeaux, France;U 657, INSERM, (33000), Bordeaux, France;Univ. de Bordeaux, (33000), Bordeaux, France;U 657, INSERM, (33000), Bordeaux, France;U 1034, INSERM, (33600), Pessac, France;

关键词: Hydroxymethylglutaryl-CoA Reductase Inhibitors;    Risk factors;    Medication adherence;    Databases, Factual;    Pharmacoepidemiology;    Insurance, Health, Reimbursement;   

DOI  :  10.1186/1471-2261-11-46

 received in 2011-01-12, accepted in 2011-07-26,  发布年份 2011

来源: Springer

【 摘 要 】

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.

【 授权许可】

Unknown   
© Latry et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.