Approaches to Statin Therapy Adherence Improvement

Abstract

Most cardiovascular diseases (CVD) are of atherosclerotic origin, and lipid disorders play significant role, setting up the cardiovascular continuum, together with other risk factors. It also known that decrease of low density lipoproteins cholesterol (CLDL) level leads to decreased occurrence of CVDs in primary and secondary prevention of the diseases. Statins, at the moment, are a standard of medical care. However, two problems remain on the way to cardiovascular risk reduction — insufficient statins prescription and low rate of archived target levels of cholesterol and CLDL. In the end of October 2017, by the initiative of Sandoz LLC, in Kazan an educational seminar was conducted, where the representatives from 12 regions discussed the issues on statin therapy adherence improvement. Seminar program included lectures, practical interactive events and general discussion. As a specifics of the seminar, the participants not only listened to lectures, but prepared proposals in interactive regimen, discussed them with the colleagues, presented and defended projects. So, every participant was merged into the problem and directly influenced the discussion. Among the participants were internists, cardiologists, neurologists. Seminar vector was directed to revealing and overcoming such barriers for statin adherence as the so­called barriers of consent, understanding and availability, that depend on clinician as well as patient and healthcare system. Also the issues were discussed on the Internet influence on “antistatin” behavior, that prefers “good” bioactive compounds for “vile” statins.

Lipid-Lowering Therapy: Impact on Cardiovascular Risk, Economic Efficiency of Innovative Medicines

“…Таким образом, популяция пациентов с ИБС, проживающих в Республике Беларусь и декларирующих прием статинов, может составлять: 1 124 917 / 100 × 7 = 78 744 человека. Известной мировой проблемой является низкая приверженность долгосрочной терапии статинами, которая является залогом проявления их положительного эффекта на сердечно-сосудистую заболеваемость и смертность [28,29]. Частично недостаточная приверженность приему статинов может быть связана с истинными или мнимыми проблемами плохой переносимости, которую связывают прежде всего с нежелательными явлениями со стороны печени и/или мышечной системы.…”

“…Таким образом, когорта пациентов, у которых невозможно реализовать долгосрочное применение статинов, в пересчете на белорусскую популяцию может составлять: 78 744 / 100 × 4,2% = 3307 человек. При непереносимости статинов пациенту с ИБС с целью коррекции дислипопротеидемии рекомендуется назначать иные гиполипидемические средства [29]. В условиях фармацевтического рынка Республики Беларусь это подразумевает применение фенофибрата или эзетимиба [8].…”

The lipid-lowering treatment after acute coronary syndrome in the real clinical practice: possible role of the pharmacogenetic interactions

“…The main lipid-lowering drugs for CAD are statins. One of the main problems is the low adherence to statins [9], resulting in a high residual risk of CAD complications. In the Swedish register of ACS (49.857 participants) 2001-2012, 20.2 % of patients used high doses of statins after ACS, while 42.7 % did not take lipid-lowering treatment after discharge from the hospital.…”