Intervention to Improve Adherence to Lipid-Lowering Medication and Lipid-Levels in Patients With an Increased Cardiovascular Risk

Nieuwkerk, Pythia T.; Nierman, Melchior C.; Vissers, Maud N.; Locadia, Mirjam; Greggers-Peusch, Phillip; Knape, Léon P.M.; Kastelein, John J.P.; Sprangers, Mirjam A. G.; Haes, Hanneke C. de; Stroes, Erik S.G.

doi:10.1016/j.amjcard.2012.04.045

Cited by 63 publications

(60 citation statements)

References 26 publications

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“…For example, a nurse-led cardiovascular risk-factor counseling composed of providing patients with personalized risk assessment, and highlighting individual modifiable risk factors, had positive effect on both adherence to statins, and lipids level in primary prevention patients [21]. Intervention composed of inhospital counselling, attention to adherence barriers, communication of discharge medications to community pharmacists and physicians, and ongoing assessment of adherence by community pharmacists had a positive effect on adherence to statins in secondary prevention patients [22].…”

Section: Discussionmentioning

confidence: 99%

An education-behavioural intervention improves adherence to statins

Kardas

2013

Open Medicine

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Section: Discussionmentioning

confidence: 99%

An education-behavioural intervention improves adherence to statins

Kardas

2013

Open Medicine

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“…In fact, the intervention was codesigned by community pharmacists and primary care doctors with the goal of establishing a standard intervention that would be able to be implemented in both of these health professional fields. In the case of interventions where reminders were used, there are studies where adherence improves after intervention in the community pharmacy and in the hospital setting . On the other hand, when the intervention is about providing education on the importance of adherence to treatment and other issues related to the disease, there are studies that do not find improvement at the end of the study in community pharmacy nor in the hospital environment .…”

Section: Discussionmentioning

confidence: 99%

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial

Oñatibia-Astibia

Malet-Larrea

Larrañaga

et al. 2019

Health Services Research

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Objective To evaluate the impact of health professionals’ intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. Study Setting Forty‐six community pharmacies and 50 primary care centers of Spain. Study Design Randomized controlled trial design (n = 746). Patients were assigned into adherent (ADH) or nonadherent group depending on their initial adherence to statins. Nonadherent patients were randomly assigned to intervention (INT) or nonintervention (NOINT) group. Patients enrolled in the INT group received an intervention depending on the cause of nonadherence. Patients in the ADH and NOINT groups received usual care. Intention‐to‐treat (ITT) analysis was performed with multiple imputation to replace the missing data. Data Collection Adherence, total cholesterol levels, and lifestyle behaviors. Findings The odds of becoming adherent during the 6 months was higher in the INT group compared to the NOINT group (OR = 1,49; 95% CI: 1.30‐1.76; P < 0.001), especially in the community pharmacy group (OR = 2.34; 95% CI: 1.81‐3.03; P < 0.001). Adherent patients showed lower values of total cholesterol compared with nonadherent patients at baseline (ADH: 200.3 mg/dL vs NOADH: 216.7 mg/dL; P < 0.001) and at the endpoint (ADH: 197.3 mg/dL vs NOADH: 212.2 mg/dL; P < 0.001). More patients enrolled in the INT group practices exercise at the end of the study (INT: +26.6 percent; P = 0.002), and a greater number of patients followed a diet to treat hypercholesterolemia (+30.2 percent; P < 0.001). Conclusions The intervention performed by health professionals, especially by community pharmacists, improved adherence to statins by hypercholesterolemic patients, and this improvement in adherence was accompanied by a reduction in total cholesterol levels and a healthier lifestyle.

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“…Results of our study showed the intervention efficacy by the decreased number of subjects with elevated values of total and lowered values of LDL cholesterol, but not of HDL cholesterol. A similar intervention study was conducted in the Netherlands, where examinees were followed up at 3, 9, and 18 months, which also showed a significant decrease in LDL cholesterol values in the intervention group [18]. Efficacy in the regulation of these CV risk factors are explained by better availability of drugs on the market and because patients find it easier to take medicines than to change their lifestyle habits.…”

Section: Discussionmentioning

confidence: 99%

“…Successful treatment of arterial hypertension and dyslipidemia depends, among other things, on adverse effects and the number of drugs a patient takes. Studies show that 90% of patients regularly take antihypertensives and statins in the first year, but only 33% do so after 3 years of therapy [18]. …”

Section: Discussionmentioning

confidence: 99%

Is a targeted and planned GP intervention effective in cardiovascular disease prevention? A randomized controlled trial

Kranjčević¹,

Marković

Lalić³

et al. 2014

Med Sci Monit

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BackgroundThe optimal intensity and duration of the intervention to achieve sustained risk reduction in patients at high and very high cardiovascular (CV) risk still need to be established. The aim of this study was to evaluate the impact of general practitioner’s (GP’s) systematic and planned intervention on total CV risk reduction and a change in individual CV risk factors.Material/MethodsThis was a cluster-randomized trial (ISRCTN31857696) including 64 practices and 3245 patients aged ≥40. The participating GPs and their examinees were randomized into an intervention or to a control group (standard care). Intervention group practitioners followed up their examinees during 1, 3, 6, 12, and 18 months. The main outcome measures were change in proportion of patients with low, moderate, high, and very high CV risk, and change in individual CV risk factors from the first to the second registration.ResultsThe proportion of patients with very high CV risk was lower in the intervention group, the same as of patients with high blood pressure, total and LDL cholesterol, and increased intake of alcohol. The mean systolic (−1.49 mmHg) and diastolic (−1.57 mmHg) blood pressure, triglycerides (−0.18 mmol/L), body mass index (−0.22), and waist (−0.4 cm) and hip circumference (−1.08 cm) was reduced significantly in the intervention group. There was no additional impact in the intervention group of other tested CV risk factors.ConclusionsSystematic and planned GP’s intervention in CVD prevention reduces the number of patients with very high total CV risk and influences a change in lifestyle habits.

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Intervention to Improve Adherence to Lipid-Lowering Medication and Lipid-Levels in Patients With an Increased Cardiovascular Risk

Cited by 63 publications

References 26 publications

An education-behavioural intervention improves adherence to statins

An education-behavioural intervention improves adherence to statins

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial

Is a targeted and planned GP intervention effective in cardiovascular disease prevention? A randomized controlled trial

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