Salt Lake City, UT—Pharmacists fill statin prescriptions every day, but they might be surprised by how few atherosclerotic cardiovascular disease (ASCVD) patients follow their cholesterol-lowering regimens.
A presentation at the American College of Cardiology Scientific Sessions in New Orleans points out that those patients can reduce their risk of a second major adverse CVD event almost 50% by taking statins as directed.
However, researchers from the Intermountain Healthcare Heart Institute in Salt Lake City determined that only about 6% of CVD patients actually followed their physicians’ instructions on taking statins.
“A lot of clinical trials have shown that statins reduce the risk of secondary outcomes, so it’s really important that they take these medications,” explained the study’s principal investigator, Heidi May, PhD. “The surprising thing that we found is that so few patients, even within an insured population, just didn't take their statin medication as prescribed.”
The study notes that past research has shown a consistent relationship between years of LDL-C reduction on statin therapy and magnitude of risk reduction. The study team sought to assess patterns of statin use among insured ASCVD patients over 5 years of follow-up.
Included in the study were more than 5,000 adult Intermountain Healthcare patients with a first encounter for ASCVD, i.e., coronary artery disease, CVD, or peripheral artery disease, from January 1999 to December 2013. The survivors, who were 77% male and had a mean age of 56, all had 5 years of SelectHealth insurance membership.
Researchers calculated the proportion of days covered for each 365-day period following the index event and adherence was defined as high (≥80%), moderate (20%-79%) or poor (<20%).
Results indicate that, in the first year, 23% of patients had high adherence to prescribed statins, with 33.6% of them having high adherence in Year 5. Of the remaining patients with moderate and poor adherence in Year 1, 16.4% and 9.8%, respectively, had high adherence in Year 5.
“Over 5 years, patients demonstrate highly variable adherence to statins,” the study authors conclude. “High adherence declined while poor adherence increased. However, some patients with initial moderate and poor adherence improved adherence in subsequent years. LDL-C reduction over 5 years has been shown to provide lifelong risk reduction, yet few patients, even with insurance, are achieving it in the real world.”
The researchers report that patients with optimal adherence—defined as following drug instructions at least 80% of the time—reduced their risk of dying or having a heart attack or stroke by nearly 50%, although only a few hundred—about 6%—of patients fell into that category by the end of the study.
In fact, one quarter of patients never filled their first statin prescription, and another 25% never filled their second.
The authors posit several reasons for nonadherence: negativity about statins, concerns about taking too many medications, worry about side effects, the incorrect belief that after a few years on statins a person is cured and doesn’t need to take them anymore, or the erroneous belief that treating high cholesterol isn’t that important.
May suggested that the importance of taking statins could be lost in the crush of information provided at hospital discharge, pointing out, “During this time, patients most likely don't feel their best, they’re probably scared about what just happened to them, and nervous about their future. They may not be able to process everything that’s happening and how to best follow up,” she said.
She advised healthcare professionals to inquire whether drug regimens are being followed. “The patients should be asked about whether or not they’re taking their statin at their follow-up appointments, especially soon after discharge,” May recommended.
« Click here to return to Weekly News Update.
A presentation at the American College of Cardiology Scientific Sessions in New Orleans points out that those patients can reduce their risk of a second major adverse CVD event almost 50% by taking statins as directed.
However, researchers from the Intermountain Healthcare Heart Institute in Salt Lake City determined that only about 6% of CVD patients actually followed their physicians’ instructions on taking statins.
“A lot of clinical trials have shown that statins reduce the risk of secondary outcomes, so it’s really important that they take these medications,” explained the study’s principal investigator, Heidi May, PhD. “The surprising thing that we found is that so few patients, even within an insured population, just didn't take their statin medication as prescribed.”
The study notes that past research has shown a consistent relationship between years of LDL-C reduction on statin therapy and magnitude of risk reduction. The study team sought to assess patterns of statin use among insured ASCVD patients over 5 years of follow-up.
Included in the study were more than 5,000 adult Intermountain Healthcare patients with a first encounter for ASCVD, i.e., coronary artery disease, CVD, or peripheral artery disease, from January 1999 to December 2013. The survivors, who were 77% male and had a mean age of 56, all had 5 years of SelectHealth insurance membership.
Researchers calculated the proportion of days covered for each 365-day period following the index event and adherence was defined as high (≥80%), moderate (20%-79%) or poor (<20%).
Results indicate that, in the first year, 23% of patients had high adherence to prescribed statins, with 33.6% of them having high adherence in Year 5. Of the remaining patients with moderate and poor adherence in Year 1, 16.4% and 9.8%, respectively, had high adherence in Year 5.
“Over 5 years, patients demonstrate highly variable adherence to statins,” the study authors conclude. “High adherence declined while poor adherence increased. However, some patients with initial moderate and poor adherence improved adherence in subsequent years. LDL-C reduction over 5 years has been shown to provide lifelong risk reduction, yet few patients, even with insurance, are achieving it in the real world.”
The researchers report that patients with optimal adherence—defined as following drug instructions at least 80% of the time—reduced their risk of dying or having a heart attack or stroke by nearly 50%, although only a few hundred—about 6%—of patients fell into that category by the end of the study.
In fact, one quarter of patients never filled their first statin prescription, and another 25% never filled their second.
The authors posit several reasons for nonadherence: negativity about statins, concerns about taking too many medications, worry about side effects, the incorrect belief that after a few years on statins a person is cured and doesn’t need to take them anymore, or the erroneous belief that treating high cholesterol isn’t that important.
May suggested that the importance of taking statins could be lost in the crush of information provided at hospital discharge, pointing out, “During this time, patients most likely don't feel their best, they’re probably scared about what just happened to them, and nervous about their future. They may not be able to process everything that’s happening and how to best follow up,” she said.
She advised healthcare professionals to inquire whether drug regimens are being followed. “The patients should be asked about whether or not they’re taking their statin at their follow-up appointments, especially soon after discharge,” May recommended.
« Click here to return to Weekly News Update.
