TY - JOUR
T1 - Predictors of adherence to statins for primary prevention
AU - Mann, Devin M.
AU - Allegrante, John P.
AU - Natarajan, Sundar
AU - Halm, Ethan A.
AU - Charlson, Mary
N1 - Funding Information:
This research was conducted while Dr. Mann was a Fellow with the Health Services Research Training Program at the Weill Medical College and Graduate School of Medical Sciences, Cornell University, supported by the Agency for Healthcare Research and Quality (T32 HS00066). Preliminary findings of this study were presented at the 12th Annual NRSA Trainees Research Conference, Seattle, Washington, June 2006. D.M.Mann(*) . E. A. Halm Division of General Internal Medicine, Mount Sinai School of Medicine, 1470 Madison Ave, Box 1087, New York, NY 10029, USA e-mail: devin.mann@mountsinai.org
PY - 2007/8
Y1 - 2007/8
N2 - 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.
AB - 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.
KW - Adherence
KW - Cardiovascular disease
KW - Health beliefs
KW - Predictor
KW - Primary prevention
KW - Statins
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U2 - 10.1007/s10557-007-6040-4
DO - 10.1007/s10557-007-6040-4
M3 - Article
C2 - 17665294
AN - SCOPUS:34548547435
SN - 0920-3206
VL - 21
SP - 311
EP - 316
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
IS - 4
ER -