Long-term Persistence in Use of Statin Therapy in Elderly Patients

Benner, Joshua S.

doi:10.1001/jama.288.4.455

Cited by 1,025 publications

(559 citation statements)

References 39 publications

(47 reference statements)

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“…Several studies have found age to be related to increased compliance (Sirey, Bruce, Alexopoulos, Perlick, Friedman, & Meyers, 2001;Kim et al, 2002;Senior, Marteau, & Weinman, 2004;Hertz, Unger, & Lustik, 2005). A few studies have found elderly patients to be more noncompliant than their younger counterparts (Benner, Glynn, Mogun, Neuman, Weinstein, & Avorn, 2002;Balbay,Annakkaya, Arbak, Bilgin, & Erbas, 2005). When assessing compliance solely among Medicaid recipients age 65 and over, Monane et al (1996) found that old age was associated with better compliance.…”

Section: E15mentioning

confidence: 99%

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Blackwell

Baugh²,

Montgomery³

et al. 2011

MMRR

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OBJECTIVES:(1) to assess non-compliance among Medicare Part D recipients for the cardiovascular medication classes; (2) to identify the probability of noncompliance for each medication class when controlling for the potential risk factors of age, gender, race/ethnic origin, census region, disease burden, dual eligibility enrollment status, Part D plan status, relative out-of-pocket (OOP) non-class costs, and relative OOP daily class costs.

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Section: E15mentioning

confidence: 99%

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Blackwell

Baugh²,

Montgomery³

et al. 2011

MMRR

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“…Several studies have characterized the problem of statin discontinuation by identifying subgroups of patients who are at high risk for discontinuing treatment 14, 19, 20, 21, 22. Few studies have described opportunities to re‐initiate statins.…”

Section: Discussionmentioning

confidence: 99%

Healthcare Utilization and Statin Re‐Initiation Among Medicare Beneficiaries With a History of Myocardial Infarction

Booth

Colantonio

Rosenson

et al. 2018

JAHA

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BackgroundContact with the healthcare system represents an opportunity for individuals who discontinue statins to re‐initiate treatment. To help identify opportunities for healthcare providers to emphasize the risk‐lowering benefits accrued through restarting statins, we determined the types of healthcare utilization associated with statin re‐initiation among patients with history of a myocardial infarction.Methods and ResultsMedicare beneficiaries with a statin pharmacy fill claim within 30 days of hospital discharge for a myocardial infarction in 2007 to 2012 (n=158 795) were followed for 182 days postdischarge to identify treatment discontinuation, defined as 60 continuous days without statins (n=24 461). Re‐initiation was defined as a statin fill within 365 days of the discontinuation date (n=13 136). Using a case‐crossover study design and each beneficiary as their own control, healthcare utilization during 0 to 14 days before statin re‐initiation (case period) was compared with healthcare utilization 30 to 44 days before statin re‐initiation (control period). The mean age of beneficiaries was 75.4 years; 52.8% were women and 81.9% were white. For routine healthcare utilization, the odds ratio (95% confidence interval) for statin re‐initiation associated with lipid panel testing was 2.65 (1.93–3.65), outpatient primary care was 1.31 (1.23–1.40), and outpatient cardiologist care was 1.38 (1.28–1.50). For acute healthcare utilization, the odds ratio (95% confidence interval) for statin re‐initiation associated with emergency department visits was 1.77 (1.31–2.40), coronary heart disease (CHD) hospitalizations was 3.16 (2.41–4.14) and non–coronary heart disease hospitalizations was 1.73 (1.49–2.01).ConclusionsThe weaker association of routine versus acute healthcare utilization with statin re‐initiation suggests missed opportunities to reinforce the importance of statin therapy for secondary prevention.

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“…Согласно многочисленным исследованиям [47][48][49][50] от 20 до 40% пациентов, ко-торым были назначены статины, прекращают их прием через 1 год.…”

Section: приверженность лечению статинамиunclassified

Hypolipidemic Therapy in Stroke Prevention: Existing Standards, Evidence-Based Medicine Data and Real Practice

Gaisenok

Rozhkov

Лишута

2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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Сердечно-сосудистые заболевания занимают лидирующие позиции в заболеваемости, смертности и инвалидизации в большинстве стран. В структуре смертности от сердечно-сосудистых заболеваний лидируют ишемическая болезнь сердца и мозговой инсульт. В статье рассмат-риваются вопросы гиполипидемической терапии статинами в аспекте профилактики острого нарушения мозгового кровообращения. Пред-ставлены основные факторы риска атеросклероза и их распространенность. Авторами освещаются существующие стандарты применения статинов, данные доказательной медицины, полученные в рандомизированных клинических исследованиях, а также данные реальной кли-нической практики. Также рассматриваются возможные перспективные направления применения статинов с целью профилактики острого нарушения мозгового кровообращения. К последним можно отнести комбинированную терапию совместно с другими гиполипидемическими средствами, а также препаратами других групп, применение статинов с более ранних возрастов, реализацию на практике плейотропных эф-фектов статинов. Авторы наглядно демонстрируют, что реальная практика применения статинов существенно отстает от идеальной, отраженной в рекомендациях и рандомизированных клинических исследованиях. Одним их ключевых факторов этого является приверженность вра-чебным рекомендациям. Представлены основные факторы, которые могут повлиять на повышение приверженности пациентов к приему статинов и повысить эффективность их применения в реальной клинической практике. Cardiovascular diseases occupy a leading position in morbidity, mortality and disability in most countries. Ischemic heart disease and stroke lead in the structure of mortality from cardiovascular diseases. The issues of lipid-lowering therapy with statins in the aspect of stroke prevention are discussed in the article. The main risk factors of atherosclerosis and their prevalence are presented. Topical standards for statin use, evidence-based medicine data obtained in randomized clinical trials, and evidence from actual clinical practice are covered. Possible promising areas of statin use for the prevention of acute cerebrovascular accident are also considered. Combination therapy together with other lipid-lowering drugs, as well as drugs of other pharmacological groups, the use of statins from earlier ages, the practical implementation of pleiotropic effects of statins can be attributed to the latter. The authors clearly demonstrate that the actual practice of using statins lags significantly behind the ideal, reflected in the recommendations and randomized clinical trials. Adherence to medical recommendations is one of the key factors in this. The main factors that can influence the increase of adherence of patients to taking statins and increase the effectiveness of their application in real clinical practice are presented.

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Long-term Persistence in Use of Statin Therapy in Elderly Patients

Cited by 1,025 publications

References 39 publications

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Healthcare Utilization and Statin Re‐Initiation Among Medicare Beneficiaries With a History of Myocardial Infarction

Hypolipidemic Therapy in Stroke Prevention: Existing Standards, Evidence-Based Medicine Data and Real Practice

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