Long-term Assessment of Psychological Well-being in a Randomized Placebo-Controlled Trial of Cholesterol Reduction With Pravastatin

Stewart, R.; Sharples, Katrina; North, Fiona; Menkes, David B; Baker, Jenny; Simes, John

doi:10.1001/archinte.160.20.3144

Cited by 80 publications

(63 citation statements)

References 52 publications

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“…In addition, we observed no significant difference as a function of LLA use, suggesting that absolute low levels rather than reduction from high lipid concentrations might be associated with depression. This is in agreement with randomized controlled trials in which no modification in depressive symptomatology has been reported in patients with, or at risk of, coronary disease receiving LLA (26,27).…”

Section: Discussionsupporting

confidence: 91%

Gender and Genotype Modulation of the Association Between Lipid Levels and Depressive Symptomatology in Community-Dwelling Elderly (The ESPRIT Study)

Ancelin

Carrière

Boulenger

et al. 2010

Biological Psychiatry

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Section: Discussionsupporting

confidence: 91%

Gender and Genotype Modulation of the Association Between Lipid Levels and Depressive Symptomatology in Community-Dwelling Elderly (The ESPRIT Study)

Ancelin

Carrière

Boulenger

et al. 2010

Biological Psychiatry

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“…16,17,34 In the current analysis of women with chest pain, we found no difference in depressive symptoms between those receiving and not receiving a cholesterol-lowering treatment. Reports of adverse mood effects of cholesterol reduction generally derive from relatively small studies.…”

Section: Discussioncontrasting

confidence: 56%

“…10,11 Based on a prior report based on WISE study participants and evidence from other investigators, neither low nor lowered cholesterol is consistently associated with hostility or anger. 17,40,41 On the other hand, it is not known if cholesterol-lowering treatments per se affect aggressive behavior or cause the feeling of aggression toward others. In experiments using nonhuman primates, animals assigned to cholesterol-lowering diets acted more aggressively and exhibited less affiliative behavior than those on a high-fat diet.…”

Section: Discussionmentioning

confidence: 99%

“…Also, there is accumulating evidence that cholesterol-lowering drugs may adversely affect the brain, cognitive performance, and mood. [12][13][14][15][16] Although such findings are not universal, 17 questions persist about the possible effects of serum cholesterol reduction on suicide and violence, 18,19 and information concerning this issue in women is particularly scarce.…”

Section: Introductionmentioning

confidence: 99%

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Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

Olson

Kelsey

Matthews

et al. 2008

Journal of Women's Health

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Aim-The aim of this study was to examine the association between the use of lipid-lowering medication and aggressive responding, hostility, cynicism, and depression scores in women undergoing coronary angiography.Methods-The cohort included 498 women from the National Heart, Lung and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. WISE is a four-center study of women with chest pain who underwent quantitative coronary angiography for suspected myocardial ischemia. The psychosocial indices included the Cook Medley Hostility questionnaire, measuring aggression, hostility, and cynicism, and the Beck Depression Inventory (BDI).Results-Compared to those not on lipid-lowering medication, women receiving lipid-lowering pharmacotherapy were older (62 vs. 55 years, p < 0.001) and had more hypertension, dyslipidemia, diabetes, and coronary artery disease (CAD, defined as ≥50% stenoses in at least one epicardial artery) (all p < 0.003). Women on lipid-lowering medication had higher aggressive responding scores than those not on medication, 3.0 ± 1.8 vs. 2.7 ± 1.7, respectively (age-adjusted p < 0.003). This association persisted after adjustment for coronary risk factors, education, and extent of angiographic disease (CAD) (p < 0.005), and after exclusion of women using psychotropic medications (p < 0.001). Hostility, cynicism, and depression scores did not differ by medication use.Conclusions-In women, lipid-lowering medication may predispose to aggression without affecting hostility or mood, but this hypothesis requires evaluation in placebo-controlled clinical trials.

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“…[45][46][47] No disutility from taking a pill everyday was assumed in the model. 50,51 In the rare case of nonfatal rhabdomyolysis or myopathy, disutility of 0.530 was applied for 1 year. 52 Utilities and life expectancies were multiplied to calculate qualityadjusted life years (QALYs).…”

Section: Costsmentioning

confidence: 99%

Improving Adherence to Lipid-Lowering Therapy in a Community Pharmacy Intervention Program: A Cost-Effectiveness Analysis

Vegter

Oosterhof²,

Boven

et al. 2014

JMCP

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BACKGROUND: Pharmaceutical care in community pharmacies has been shown to improve adherence to chronic therapies. Long-term impact on clinical outcomes or medical cost savings, however, remains understudied. OBJECTIVE: To estimate the cost-effectiveness of a pharmaceutical care intervention program in Dutch community pharmacies that improved patients' adherence to lipid-lowering therapy. METHODS: An economic evaluation was performed using a time-dependent Markov model from the health care payer perspective. Participants were patients initiating lipid-lowering therapy for primary prevention (40%) or secondary prevention (60%) of cardiovascular events (CVEs). The intervention was the pharmaceutical care program MeMO (Medication Monitoring and Optimisation) in 9 community pharmacies in the Netherlands, based on continuous monitoring and optimization of lipid-lowering therapy in new patients. The follow-up period of the program was 1 year. The main outcome of the intervention program was discontinuation of lipid-lowering therapy. This outcome was extrapolated in the economic model to lifelong costs, quality of life, reductions in cardiovascular events, and incremental cost-effectiveness ratios. RESULTS: Patients in the MeMO program had a lower risk for therapy discontinuation, RR = 0.49 (0.37 to 0.66); the effectiveness was similar in primary and secondary prevention. In a cohort of 1,000 primary and secondary prevention patients, the MeMO program resulted in a reduction of 7 nonfatal strokes, 2 fatal strokes, 16 nonfatal myocardial infarctions (MIs), 7 fatal MIs, and 16 revascularizations over patients' lifetime. Additional medication, disease management, and intervention costs in the MeMO program were €411,000; the cost savings due to reduced CVEs were €443,000. The MeMO program resulted in 84 quality-adjusted life-years (QALYs) gained and net cost savings of €32,000. Clinical benefits and cost savings were highest in the secondary prevention population. CONCLUSION: Pharmaceutical care in community pharmacies can improve statin therapy adherence, resulting in better prevention of CVEs. The MeMO program resulted in considerable clinical benefits and net cost savings. Programs by community pharmacies targeted at improving adherence may provide good value for money, and health care insurers should consider reimbursing these activities.

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Long-term Assessment of Psychological Well-being in a Randomized Placebo-Controlled Trial of Cholesterol Reduction With Pravastatin

Cited by 80 publications

References 52 publications

Gender and Genotype Modulation of the Association Between Lipid Levels and Depressive Symptomatology in Community-Dwelling Elderly (The ESPRIT Study)

Gender and Genotype Modulation of the Association Between Lipid Levels and Depressive Symptomatology in Community-Dwelling Elderly (The ESPRIT Study)

Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

Improving Adherence to Lipid-Lowering Therapy in a Community Pharmacy Intervention Program: A Cost-Effectiveness Analysis

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