Cardiovascular Morbidity Associated with Nonadherence to Statin Therapy

Blackburn, David; Dobson, Roy; Blackburn, James; Wilson, Thomas W.

doi:10.1592/phco.2005.25.8.1035

Cited by 101 publications

(60 citation statements)

References 27 publications

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“…The statin class of medications was selected for analysis because adherence to these medications is known to be poor, 6,9-12 and our research group has experience with statin adherence analyses using Saskatchewan health data. 7,10 Community Pharmacy Selection Community pharmacy companies that provide service to the urban centers in Saskatchewan were subjectively grouped into I n Canada, most prescription medications are dispensed by licensed pharmacists through community pharmacies. Because of their frequent contact with patients, it has been suggested that community pharmacists are in an ideal position to identify and improve medication nonadherence.…”

Section: Subject Selectionmentioning

confidence: 99%

“…4 Medication nonadherence is a global problem and is a predictor of negative patient outcomes. [5][6][7] Although many studies…”

Section: Subject Selectionmentioning

confidence: 99%

“…In a sensitivity analysis, we calculated adherence for statins using a different method, the fill frequency (dispensings per months of observation) 7 and re-analyzed the data as described above. This sensitivity analysis resulted in trends similar to our primary analysis (data not shown).…”

Section: Retrospective Observational Assessment Of Statin Adherence Amentioning

confidence: 99%

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Retrospective Observational Assessment of Statin Adherence Among Subjects Patronizing Different Types of Community Pharmacies in Canada

Evans

Eurich²,

Lamb³

et al. 2009

JMCP

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of 2,292 (37.9%), 874 of 1,887 (46.3%), and 457 of 975 (46.9%) subjects in the department-mass merchandise, chain-franchise, and independentbanner categories, respectively, had a statin adherence level of at least 80% (P < 0.001). In logistic regression analysis, pharmacy category type was significantly associated with statin adherence; subjects in the chainfranchise and independent-banner categories were more likely to be adherent to their statin medications during their observation periods than were those in the department-mass merchandise category (adjusted odds ratio [OR] = 1.36, 95% CI = 1.23-1.50, P < 0.001 and OR = 1.39, 95% CI = 1.24-1.57, P < 0.001, respectively). From the index date through day 1,094, 1,752 of 2,292 (76.4%), 1,475 of 1,887 (78.2%), and 795 of 975 (81.5%) subjects remained pharmacy-loyal in the department-mass merchandise, chainfranchise, and independent-banner categories, respectively (P = 0.006). Controlling for several potential confounders using logistic regression, independent-banner pharmacy patrons were more likely to remain pharmacy-loyal during their observation periods than were those patronizing department-mass merchandise (adjusted OR = 1.34, 95% CI = 1.16-1.54, P < 0.001) or chain-franchise stores (adjusted OR = 1.22, 95% CI = 1.06-1.42, P = 0.009).CONCLUSION: One year after their first statin fill, subjects demonstrated low rates of adherence, ranging from 48% to 55%, regardless of the type of pharmacy they patronized. Although the differences by type of pharmacy reached statistical significance, their clinical importance is not evident, reinforcing the fact that the problem of nonadherence appears to exist among all types of community pharmacies, regardless of their categorization. Manag Care Pharm. 2009;15(6):476-84 Copyright © 2009, Academy of Managed Care Pharmacy. All rights reserved. J ABSTRACTBACKGROUND: Community pharmacies vary widely in terms of ownership structures, location, and dispensing policies. It is unknown if an association exists between the type of community pharmacy and the degree of medication adherence exhibited by patrons-patients.

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Section: Subject Selectionmentioning

confidence: 99%

“…4 Medication nonadherence is a global problem and is a predictor of negative patient outcomes. [5][6][7] Although many studies…”

Section: Subject Selectionmentioning

confidence: 99%

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Retrospective Observational Assessment of Statin Adherence Among Subjects Patronizing Different Types of Community Pharmacies in Canada

Evans

Eurich²,

Lamb³

et al. 2009

JMCP

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“…Nonadherence to diabetes medications as well as statin therapy has been demonstrated to result in adverse outcomes, including myocardial infarction, excess hospitalizations, and mortality. 3,21 Medication adherence that results in just a 1% reduction in HbA1c can lead to a 37% reduction in microvascular complications and a 42% risk reduction in diabetes-related death. [22][23][24] Although our study resulted in a 0.5% further reduction in HbA1c for the OPCS group compared with the usual care group, 61% of the OPCS group had a 1% or more reduction in HbA1c, compared with 52% of the usual care group (P = 0.008).…”

Section: ■■ Discussionmentioning

confidence: 99%

Evaluation of an Outpatient Pharmacy Clinical Services Program on Adherence and Clinical Outcomes Among Patients with Diabetes and/or Coronary Artery Disease

Spence

Makarem²,

Reyes³

et al. 2014

JMCP

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BACKGROUND: Poor medication adherence among patients with chronic diseases can result in complications and increased health care expenditures. An outpatient pharmacy clinical service (OPCS) program targeted nonadherent diabetes mellitus (DM) and/or coronary artery disease (CAD) patients with hemoglobin A1c (HbA1c) and/or low-density lipoprotein cholesterol (LDL-C) outside clinical goals. Pharmacists engaged identified patients with a face-to-face B-SMART consult, a consultation methodology to identify Barriers to medication adherence, work on Solutions to identified barriers, Motivate patients, recommend Adherence tools, reinforce the pharmacist-patient Relationship, and Triage if needed, to other services such as health education to improve outcomes.

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“…There is strong international evidence that cost influences adherence (Goldman et al 2007). A wealth of literature demonstrates the adverse effects of prescription drug non-adherence, such as increased emergency room visits, morbidities and mortalities (Blackburn et al 2005;Heisler et al 2010;Mojtabai and Olfson 2003;Tamblyn et al 2001). The heavy reliance of Canada' s universal health insurance coverage system on private prescription drug plans also means that significant use of cost-shifting mechanisms may have important equity implications.…”

Section: Discussionmentioning

confidence: 99%

Cost-Control Mechanisms in Canadian Private Drug Plans

Kratzer¹,

McGrail²,

Strumpf³

et al. 2013

hcpol

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Approximately 68% of Canadians receive prescription drug coverage through an employersponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian.Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and

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Cardiovascular Morbidity Associated with Nonadherence to Statin Therapy

Cited by 101 publications

References 27 publications

Retrospective Observational Assessment of Statin Adherence Among Subjects Patronizing Different Types of Community Pharmacies in Canada

Retrospective Observational Assessment of Statin Adherence Among Subjects Patronizing Different Types of Community Pharmacies in Canada

Evaluation of an Outpatient Pharmacy Clinical Services Program on Adherence and Clinical Outcomes Among Patients with Diabetes and/or Coronary Artery Disease

Cost-Control Mechanisms in Canadian Private Drug Plans

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