Persistence With Statins in Primary Prevention of Cardiovascular Disease: Findings From a Cohort of Spanish Workers

Abstract

Our analysis of a cohort of healthy male workers revealed poor statin persistence. These findings underscore the need for a better understanding of patterns of statin use, especially in apparently healthy individuals, and for the incorporation of patient behavior into prescribing decisions.

New Male Users of Lipid-Lowering Drugs for Primary Prevention of Cardiovascular Disease: The Impact of Treatment Persistence on Morbimortality. A Longitudinal Study

“…Multiple factors appear to influence persistence with these drugs, including sociodemographic characteristics, medical history, and healthcare utilization [ 19 ]. A previous study of the persistence with lipid-lowering drugs in the AWHS cohort [ 7 ] identified the low age of the population as a key contributing factor to poor persistence. In the present study, there were differences between persistent and nonpersistent users in age, which was also higher in persistent users, and SCORE value, which was significantly higher in the persistent group.…”

“…For example, only volunteer subjects are included in these trials, and patients and their circumstances are monitored much closer than typically occurs in routine practice [ 6 ]. On the other hand, real-world factors, such as contextual and behavioural patient characteristics, like real-world patterns of treatment use, contribute significantly to drug effectiveness [ 7 ] All these facts help explain the differences observed between randomized clinical trials and observational studies in terms of treatment efficacy and effectiveness. Therefore, treatment effectiveness and safety should be evaluated based on evidence obtained from observational studies [ 8 ].…”

Reinitiation of Statin Therapy After Discontinuation: A Meta-analysis

“…5 The robustness of pooled estimates was determined through leave-one-out sensitivity assessments. Analyses were performed with OpenMeta Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 2007 Korhonen et al, 8 2011 Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 2007 Korhonen et al, 8 2011 Upmeier et al, 9 2014 Malo et al, 10 2017 Booth et al, 11 2017 Gibson et al, 12 2015 Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 2007 Korhonen et al, 8 2011 Upmeier et al, 9 2014 Caspard et al, 13 2005 Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 2007 Korhonen et al, 8 2011 Upmeier et al, 9 2014 Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 2007 Korhonen et al, 8 2011 Brookhart et al, 6 2007 Vinogradova et al, 7 2007 Vinogradova et al, 7 studies, statin discontinuation was defined by a refill gap ranging from 56 to 183 days and reinitiation as the dispensing of a statin prescription after a period of discontinuation. Across the studies, 42.0% (interquartile range, 37.2%-48.1%) of statin users discontinued their medication over a follow-up period ranging from 6 months to 12 years.…”

“…Among the discontinuers, pooled proportions of 37.5% (95% CI, 34.7%-40.4%; I 2 ¼99.7%) and 50.6% (95% CI, 46.2%-55.0%; I 2 ¼99.9%) reinitiated within 6 months and 1 year, respectively, after discontinuation. The proportion of discontinuers who were likely to restart their statin treatment increased with duration of follow-up (Figure), [6][7][8][9][10][11][12][13] reaching 78.0% (95% CI, 74.0%-82.0%; I 2 ¼99.9%) and 87.8% (95% CI, 85.9%-89.6%; I 2 ¼99.4%) at 5 and 10 years, respectively. The pooled estimates were unchanged by leave-one-out sensitivity analyses (plots not shown).…”

Prescribing pattern of antihypertensive drugs in two European cohorts: a population-based database study

“…Drug effectiveness is significantly influenced by patient adherence and persistence [20]. Previous studies conducted in both populations [11,21] have revealed suboptimal patient persistence for drugs other than antihypertensives, suggesting that persistence with antihypertensive drugs may also be suboptimal.…”