How Do We Improve Patient Compliance and Adherence to Long-Term Statin Therapy?

Abstract

Statins are highly effective drugs prescribed to millions of people to lower LDL-cholesterol and decrease cardiovascular risk. The benefits of statin therapy seen in randomized clinical trials will only be replicated in real-life if patients adhere to the prescribed treatment regimen. But, about half of patients discontinue statin therapy within the first year, and adherence decreases with time. Patient, physician and healthcare system-related factors play a role in this problem. Recent studies have focused more on the patients’ perspectives on non-adherence. Adverse events are cited as the most common cause of statin discontinuation; thus, the healthcare provider must be willing to ally and dialogue with patients to address concerns and assess the risks and benefits of continued statin therapy.

Lifestyle factors as predictors of nonadherence to statin therapy among patients with and without cardiovascular comorbidities

“…1 For statins, the average prevalence of nonadherence, defined as taking less than 80% of the prescribed medication, was as high as 46%. 1 Multiple patient-, physician-and health system-related factors are known to affect adherence to long-term drug treatment; 2 however, easily detectable predictors of nonadherence are lacking.…”

Cost-effectiveness of statin treatment for primary prevention in conditions of real-world adherence – Estimates from the Finnish prescription register

“…Therefore concerted effort is needed to motivate the patients who have been prescribed statins to actually take their medication in order to achieve the full benefit from investment in statins. However, improving patients' adherence is not easy because of the complexity of medication-taking behavior [36]. Different risk functions and guidelines can lead to very different treatment decisions [37].…”

Do We Need A Wider Therapeutic Paradigm For Heart Failure With Comorbidities?: A Remote Australian Perspective

“…Differences predominate in side effect profiles, drug interactions, potency and level of evidence from RCT. Compliance, at best approaching 50-70%, 50% stop at 1 year due to side effects, impacts on optimal benefits [72][73][74][75][76]. Several agents to consider: Fluvastatin XR which is less potent but least likely to exert muscle toxicity and; Ezetrol, a novel agent with lower potency where some consider the jury still out from concerns of long term cancer risk and strength of evidence, can fill this space with its combination as Vytorin which has positive outcomes in high risk CRF cohort [77,78].…”