Lipid management across Europe in the real-world setting: a rapid evidence review

Barrios, Vivencio; Soronen, Jarkko; Carter, Angela M.; Anastassopoulou, Anastassia

doi:10.1080/03007995.2021.1973396

Cited by 22 publications

(15 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This response is consistent with epidemiological data published in the IBERICAN study, conducted among PC physicians in Spain [26], and with other surveys, such as Plana et al, where physicians prioritized DM and CVD, without mentioning obesity [27]. The responses provided seem not only to be in line with reality and with published data, but also to be sincere, since they acknowledge that the most widely used strategy is moderate-intensity statins, as in other developed countries [28]; this could justify the low degree of control of patients with dyslipidemia in our country [29]. We consider that, with the availability of new therapies, it is very important to know the degree of control of dyslipidemia bearing in mind the new targets, to reveal the actual situation and to take measures to improve the cardiovascular prognosis in our population [30].…”

Section: Discussionsupporting

confidence: 89%

Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey—TERESA-Opinion Study

Pallarés-Carratalá

Barrios

Fierro-González³

et al. 2023

IJERPH

Self Cite

View full text Add to dashboard Cite

Objective: The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice. Materials and methods: An ecological study was carried out, in which the physicians were invited to participate by means of an online letter. Data were collected at a single timepoint and were based only on the experience, knowledge, and routine clinical practice of the participating physician. Results: A total of 300 physicians answered the questionnaire and estimated the prevalence of dyslipidemia between 2% and 80%. They estimated that 23.5% of their patients were high-risk, 18.2% were very high-risk, and 14.4% had recurrent events in the last 2 years. The PC physicians considered that 61.5% of their patients achieved the targets set. The participants fixed the presence of side-effects to statins at 14%. The statin that was considered safest with regard to side-effects was rosuvastatin (69%). Conclusions: PC physicians in Spain perceive that the CVR of their patients is high. This, together with the overestimation of the degree of control of LDL-C, could justify the inertia in the treatment of lipids. Moreover, they perceive that one-sixth of the patients treated with statins have side-effects.

show abstract

Section: Discussionsupporting

confidence: 89%

Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey—TERESA-Opinion Study

Pallarés-Carratalá

Barrios

Fierro-González³

et al. 2023

IJERPH

Self Cite

View full text Add to dashboard Cite

show abstract

“…Adherence to pharmacotherapies can help achieve guideline-recommended LDL-C goals and thereby reduce long-term CV outcomes in high-risk patients; however, poor adherence limits the benefit of such therapies [ 19 ]. A recent meta-analysis of real-world lipid management studies across Europe showed that adherence to LLTs was variable and ranged between 46% and 92% [ 27 ], which was lower than our data suggest, with adherence ranging between 84% and 93%.…”

Section: Discussioncontrasting

confidence: 88%

Retrospective real-world analysis of adherence and persistence to lipid-lowering therapy in Germany

Koenig,

Lorenz,

Beier

et al. 2023

Clin Res Cardiol

View full text Add to dashboard Cite

Background Cardiovascular disease is the leading cause of mortality in Germany. Cardiovascular risk can be mitigated with long-term lipid-lowering therapies (LLTs) that reduce levels of low-density lipoprotein cholesterol. Although effective, risk mitigation is hindered by poor persistence and adherence. Objective To investigate real-world persistence and adherence to LLTs through 36 months post-initiation. Methods This retrospective cohort study included patients with dyslipidemia who were newly prescribed LLTs between July and December 2017, using anonymized prescription data from the Insight Health™ Patient Insight Tool, and followed up until March 2021. Persistence and adherence to the therapies were stratified by age and sex. The proportion of days covered (PDC) was used to measure adherence. Results Patients with dyslipidemia and newly prescribed statins (n = 865,732), ezetimibe (n = 34,490), or anti-proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (anti-PCSK9 mAbs; n = 1940) were included. Persistence to LLTs declined gradually across all treatment subgroups and was lower in women than men. Adherence, calculated as the mean PDC at the end of the analysis period (July 2017‒March 2021) was 0.84, 0.92, and 0.93 for statins, ezetimibe, and anti-PCSK9 mAbs, respectively. Among patients who discontinued treatment, mean treatment duration was 265, 255, and 387 days for statins, ezetimibe, and anti-PCSK9 mAbs, respectively. Only ~ 10% of patients persisted between 201 and 300 days. By Day 300, 71% of patients on statins had discontinued treatment. At 36 months, overall persistence rates were lowest with statins (20.6%), followed by ezetimibe (22.3%) and anti-PCSK9 mAbs (50.9%). Conclusions High non-persistence rates were observed across all LLT regimens analyzed, with the lowest persistence rates observed with statins. Graphical Abstract

show abstract

“…A study in older adults identified 4 distinct trajectories of statin use, out of which 3 accounted for non-adherence: gradual decline (16.8%), gaps in adherence (17.2%), and rapid discontinuation (7.8%), with only 58.2% of patients presenting high or nearly perfect adherence ( Vadhariya et al, 2019 ). Not surprisingly, a recent meta-analysis proved suboptimal lipid management across Europe, and found adherence to lipid-lowering therapies to range between 46% and 92% ( Barrios et al, 2021 ). In patients discharged with acute coronary syndromes in China, 72% adhered to statin therapy after 6 months only ( Xie et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Statins use amidst the pandemic: prescribing, dispensing, adherence, persistence, and correlation with COVID-19 statistics in nationwide real-world data from Poland

Kardas,

Kwiatek,

Włodarczyk

et al. 2024

Front. Pharmacol.

View full text Add to dashboard Cite

BackgroundAdherence to medications presents a significant challenge in healthcare. Statins, used in primary and secondary prevention of cardiovascular disease, are of particular importance for public health. The outbreak of the COVID-19 pandemic resulted in additional healthcare system-related barriers impeding the execution of therapies. This study aimed to assess the use of as well as adherence and persistence to statins in a national cohort of 38 million of Polish citizens during pandemic.MethodsA retrospective analysis of prescription and dispensation data for all statins users from the national payer organization covering the years 2020–2022 was conducted. Medication adherence was assessed using the Medication Possession Ratio, for persistence the 30-day cut-off was accepted. National data on COVID-19 cases and COVID-19 related deaths were obtained from ECDC.ResultsThe analysis identified 7,189,716 Polish citizens (approximately 19% of Polish population) who were dispensed at least 1 pack of statins within the study period. Over that time, there was a continuous significant increasing trend in prescribing and dispensing of statins. Despite a total increase of 18.9% in the number of prescribed tablets, the percentage of tablets dispensed remained similar, averaging 86%. Overall percentage of adherent patients was 48.2%. For a random sample of 100,000 patients, the mean period of continuous therapy in 2022 was 6.2+/- 5.3 months. During the lockdown period, the mean number of prescribed and dispensed tablets was lower by 6.8% and 5.9%, respectively (p < 0.05). However, fluctuations in the number of COVID-19 cases or COVID-19-related deaths per week had no major impact on the prescribing and dispensing of statins.ConclusionOver the time of pandemic, there was a continuous increase in the number of statin tablets prescribed and dispensed in Poland. This suggests that, despite the potential limitations posed by COVID-19, access to statins remained easy, which may be attributed to the mass-scale implementation of the national e-prescription system. However, it is crucial to realise that approximately 1/7 of prescribed statin doses were never dispensed, and the overall levels of adherence and persistence were low. This underscores the necessity for concerted efforts to change this scenario in Poland.

show abstract

Lipid management across Europe in the real-world setting: a rapid evidence review

Cited by 22 publications

References 71 publications

Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey—TERESA-Opinion Study

Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey—TERESA-Opinion Study

Retrospective real-world analysis of adherence and persistence to lipid-lowering therapy in Germany

Statins use amidst the pandemic: prescribing, dispensing, adherence, persistence, and correlation with COVID-19 statistics in nationwide real-world data from Poland

Contact Info

Product

Resources

About