Associations between patients’ risk attitude and their adherence to statin treatment – a population based questionnaire and register study

Barfoed, Benedicte Marie Lind; Paulsen, Maja Skov; Christensen, Peter O.; Halvorsen, Peder Andreas; Kjær, Trine; Larsen, Mogens Lytken; Larsen, Pia Veldt; Nielsen, Jesper Bo; Søndergaard, Jens; Jarbøl, Dorte Ejg

doi:10.1186/s12875-016-0423-1

Cited by 12 publications

(9 citation statements)

References 40 publications

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“…Among the study limitations was lack of information on compliance to statin therapy, however, this has been reported to be high (>80%) in Denmark . In addition, we cannot exclude some misclassification in the ascertainment of cause‐specific death from endometrial cancer or other causes as this information is based on death certificates and thus prone to some misclassification, notably among elderly patients .…”

Section: Discussionmentioning

confidence: 99%

“…One possibility is that the differences in the strength of the inverse associations might be explained by higher compliance to statin therapy in our study population. Adherence to statin treatment is known to be high in Denmark, whereas it has been reported to be low in other countries . Second, our exposure definition of statin use was based on prescriptions that were actually dispensed and purchased at pharmacies, whereas the study by Sanni et al was based on prescriptions issued by general practitioners, of which a fair proportion may not to be filled afterwards .…”

Section: Discussionmentioning

confidence: 99%

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Statin use and mortality among endometrial cancer patients: a Danish nationwide cohort study

Sperling

Verdoodt

Hansen

et al. 2018

Intl Journal of Cancer

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Statin use has been linked to improved prognosis of some cancer types, however, for endometrial cancer, the results are equivocal. We therefore examined the effect of statin use on endometrial cancer mortality. From the Danish Cancer Registry, we identified all women in Denmark aged 30-84 years with primary endometrial cancer during 2000-2012. Data on drug use, mortality outcomes and potential confounders were retrieved from nationwide registries. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for endometrial cancer-specific and other-cause mortality associated with statin use. Among 6,694 endometrial cancer patients, 753 died from endometrial cancer and 765 from other causes during a median follow-up of 4.5 year (interquartile range: 1.9-8.1). We observed an inverse association between time-varying postdiagnosis statin use (≥2 prescriptions) and endometrial cancer mortality (HR: 0.61, 95% CI: 0.48-0.77) compared to non-use (<2 prescriptions). The associations did not differ substantially by intensity or cumulative amount of statin use. In secondary analyses including prediagnosis statin use, we observed reduced mortality among both continuing (pre- and postdiagnosis) users (HR 0.70, 95% CI 0.53-0.92) and new (postdiagnosis only) users (HR 0.43, 95% CI 0.29-0.65) compared to "never users." In sensitivity analyses with fixed exposure periods after the endometrial cancer diagnosis, the inverse association was more pronounced more than 5 years after the diagnosis. Our findings suggest that statin use may be associated with improved survival in endometrial cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Statin use and mortality among endometrial cancer patients: a Danish nationwide cohort study

Sperling

Verdoodt

Hansen

et al. 2018

Intl Journal of Cancer

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“…35 We had no information on the compliance to statin and other drug use among the ovarian cancer patients, however, in order to minimize the influence of non-compliance, we required at least two prescriptions for all included drugs in the analyses in order to be classified as a user. Furthermore, the general compliance to statin therapy in Denmark has been reported high (>80%), 36,37 although no evaluation has been performed specifically for ovarian cancer patients.…”

Section: Cancer Epidemiologymentioning

confidence: 99%

Statin use and mortality among ovarian cancer patients: A population‐based cohort study

Verdoodt

Hansen

Kjær

et al. 2017

Intl Journal of Cancer

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Statin use has been suggested to improve prognosis in cancer patients, however, for ovarian cancer, the evidence is sparse. From the Danish Cancer Registry, we identified patients aged 30-84 years with a histologically verified first diagnosis of epithelial ovarian cancer between 2000 and 2013. Data on filled prescriptions, death, and potential confounding factors were obtained from nationwide registers. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between post-diagnostic statin use and all-cause or ovarian cancer-specific mortality. Among 4,419 patients with epithelial ovarian cancer, post-diagnostic statin use was not statistically significantly associated with all-cause (HR: 0.90, 95% CI: 0.78-1.04) or ovarian cancer-specific mortality (HR: 0.90, 95% CI: 0.76-1.08). There was little evidence of a dose-response relationship and the neutral associations persisted in sensitivity analyses. In women with endometrioid or clear cell tumour histology, cancer-specific mortality was reduced by 30-40% among statin users compared to non-users, however the analyses were limited by small numbers. Significantly reduced mortality with statin use was observed in subcohorts of new users of statins and of patients not using low-dose aspirin. In conclusion, we found no strong evidence of an association between post-diagnostic statin use and reduced mortality in ovarian cancer patients. However, our finding of potential differential susceptibility to statins among patients with different histologic types of ovarian cancer warrants further evaluation.

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“…If patients are unwilling to accept or adhere to treatment regimens, the investment will have been in vain ( Horne and Weinman, 1999 ). Many studies have shown that this is indeed the case for sizeable proportions of patient groups who are, for instance, prescribed statins for prevention of CHD ( Barfoed et al, 2016 ).…”

Section: Introductionmentioning

confidence: 98%

Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey

Jarbøl

Larsen

Gyrd‐Hansen

et al. 2017

Preventive Medicine Reports

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Preferences for medication treatment versus lifestyle changes are of major importance in the management of chronic diseases. This study aims to investigate determinants of preference for lifestyle changes versus medication for prevention of cardiovascular disease as well as determinants of respondents' beliefs in their ability to maintain lifestyle changes.A representative sample of 40–60-year old Danish inhabitants was in 2012 invited to a survey and were asked to imagine that they had been diagnosed as being at increased risk of heart disease. Subsequently they were presented with a choice between a preventive medical intervention versus lifestyle change. The study population for the present paper comprises 1069 participants.A total of 962 participants preferred lifestyle changes to medication treatment. Significant determinants for preferring lifestyle changes were female gender and high level of physical activity. Significant determinants for not opting for lifestyle changes were being self-employed, poor self-rated health and smoking. Low educational attainment, lifestyle risk factors, self-reported health-related challenges and prior experience with heart disease were associated with a low belief in ability to maintain lifestyle changes.For conclusion we found a pervasive preference for lifestyle changes over medical treatment when individuals were promised the same benefits. Lifestyle risk factors and socioeconomic characteristics were associated with preference for lifestyle changes as well as belief in ability to maintain lifestyle changes. For health professionals risk communication should not only focus on patient preferences but also on patients' beliefs in their own ability to initiate lifestyle changes and possible barriers against maintaining changes.

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Associations between patients’ risk attitude and their adherence to statin treatment – a population based questionnaire and register study

Cited by 12 publications

References 40 publications

Statin use and mortality among endometrial cancer patients: a Danish nationwide cohort study

Statin use and mortality among endometrial cancer patients: a Danish nationwide cohort study

Statin use and mortality among ovarian cancer patients: A population‐based cohort study

Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey

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