Predictors of adherence to statins for primary prevention

Devin M. Mann, John P. Allegrante, Sundar Natarajan, Ethan A. Halm, Mary Charlson

Research output: Contribution to journalArticle

109 Scopus citations

Abstract

Purpose: Statins are potent drugs for reducing cholesterol and cardiovascular disease; however, their effectiveness is significantly compromised by poor adherence. This prospective study was designed to identify potentially modifiable patient factors including medication, disease, and diet beliefs related to statin adherence. Methods: Veterans (n=71) given their first prescription of a statin for primary prevention were interviewed at baseline, 3 months, and 6 months regarding medication, disease, and diet beliefs along with self-reported statin adherence. Results: At 6-month follow-up, 55% of the cohort was non-adherent with 10% reporting never having started their statin, 50% reporting misconceptions about the duration of treatment and a median use of <2 months among those who discontinued their statin. Multivariate predictors of non-adherence were expected short treatment duration (OR=3.6, 1.4-9.4), low perceived risk of myocardial infarction (OR=3.1, 1.1-8.7), concern about potential harm from statins (OR=2.5, 1.0-6.3), being Hispanic (OR=3.9, 1.0-15.2), and younger age (OR=4.2, 1.1-15.8). Conclusions: Poor adherence to statins was common in this primary prevention population with frequent early discontinuation despite access to low-cost medicines. Patient factors regarding the perception of risk, toxic effects of medication, expected treatment duration, as well as socio-demographic factors, were significant predictors of poor adherence and warrant further exploration.

Original languageEnglish (US)
Pages (from-to)311-316
Number of pages6
JournalCardiovascular Drugs and Therapy
Volume21
Issue number4
DOIs
StatePublished - Aug 1 2007

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Keywords

  • Adherence
  • Cardiovascular disease
  • Health beliefs
  • Predictor
  • Primary prevention
  • Statins

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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