Patient-Associated Characteristics Influencing the Risk for Non-Persistence with Statins in Older Patients with Peripheral Arterial Disease

Wawruch, Martin; Wimmer, Gejza; Murı́n, J; Paduchova, Martina; Tesař, Tomáš; Hlinkova, Lubica; Slavkovský, Peter; Fábryová, Lubomı́ra; Aarnio, Emma

doi:10.1007/s40266-019-00689-2

Cited by 13 publications

(22 citation statements)

References 44 publications

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“…For the register-based retrospective cohort study described in this manuscript, a cohort of 8330 statin users aged ≥65 years, in whom PAD was newly diagnosed between 1 January and 31 December 2012, was used. This cohort was analyzed in our previous manuscript focused on the analysis of non-persistence with statin treatment [ 11 ]. The selection of patients for the study cohort is described in detail in that manuscript.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, non-persistent subjects were more likely to be female, new statin users, those who started treatment with atorvastatin or rosuvastatin, and those who had a higher co-payment. On the other hand, persistent subjects were more likely to be older, had a history of ischemic stroke or had diabetes mellitus, had a general practitioner as index prescriber, had a higher overall number of medications, and were using certain CV co-medications (cardiac glycosides, loop diuretics, and mineralocorticoid receptor antagonists) [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…The same patient- and statin-related characteristics as those evaluated in our previous study focused on the analysis of non-persistence [ 11 ] were analyzed as factors potentially associated with non-adherence in the study described in this manuscript. Data on these characteristics were collected at the time of inclusion in the study.…”

Section: Methodsmentioning

confidence: 99%

“…Data on these characteristics were collected at the time of inclusion in the study. The only exception were the data on the history of CV events (MI, stroke, and transient ischemic attack) which were recorded within a period of 5 years before the index date of the study described in our previous manuscript (i.e., the date of the first dispensation of statin after the PAD diagnosis) [ 11 ]. Criteria for the evaluation of statin intensity were also described in detail in our previous manuscript [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…Persistence represents the length of time between initiation and the last dose which precedes discontinuation [ 9 , 10 ]. Our previous study [ 11 ] was focused on the analysis of non-persistence with statin treatment in the group of 8330 PAD patients aged ≥65 years. During the 5-year follow-up, non-persistence was recorded in 2977 (37.5%) subjects.…”

Section: Introductionmentioning

confidence: 99%

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Non-Adherence to Statin Treatment in Older Patients with Peripheral Arterial Disease Depending on Persistence Status

et al. 2020

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The effectiveness of statins in secondary prevention of peripheral arterial disease (PAD) largely depends on patients’ adherence to treatment. The aims of our study were: (a) to analyze non-adherence during the whole follow-up in persistent patients, and only during persistence for non-persistent patients; (b) to identify factors associated with non-adherence separately among persistent and non-persistent patients. A cohort of 8330 statin users aged ≥65 years, in whom PAD was newly diagnosed between January 2012–December 2012, included 5353 patients persistent with statin treatment, and 2977 subjects who became non-persistent during the 5-year follow-up. Non-adherence was defined using the proportion of days covered <80%. Patient- and statin-related characteristics associated with non-adherence were identified with binary logistic regression. A significantly higher proportion of non-adherent patients was found among non-persistent patients compared to persistent subjects (43.6% vs. 29.6%; p < 0.001). Associated with non-adherence in both persistent and non-persistent patients was high intensity statin treatment, while in non-persistent patients, it was employment and increasing number of medications. In patients with a poor adherence during their persistent period, an increased risk for discontinuation may be expected. However, there is also non-adherence among persistent patients. There are differences in factors associated with non-adherence depending on patients’ persistence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-Adherence to Statin Treatment in Older Patients with Peripheral Arterial Disease Depending on Persistence Status

et al. 2020

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Regularity and Continuity of GP Contacts and Use of Statins Amongst People at Risk of Cardiovascular Events

et al. 2021

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BACKGROUND: Regularity and continuity of general practitioner (GP) contacts are associated with reduced hospitalisation. Opportunities for improved medication management are cited as a potential cause. OBJECTIVE: Determine associations between continuity and regularity of primary care and statin use amongst individuals at risk of cardiovascular disease (CVD) outcomes. DESIGN: Observational cohort study using self-report and administrative data from 267,153 participants of the Sax Institute's 45 and Up Study conducted in New South Wales, Australia. from 2006 to 2009. Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data, from Services Australia, were linked to survey, hospital and death data by the NSW Centre for Health Record Linkage. PARTICIPANTS: The 45 and Up Study participants at risk of CVD outcomes based on self-report and administrative data, divided into existing users and potential users based on dispensing records through the exposure period. MAIN MEASURES:The Continuity of Care index (COC), measuring whether patients see the same GP, and an index assessing whether GP visits are on a regular basis, measured from July 2011 to June 2012. Amongst potential users, statin initiation from July 2012 to June 2013 was assessed using logistic regression; amongst existing users, adherence was assessed from July 2012 to June 2015 using Cox regression (non-adherence being 30 days without statins). KEY RESULTS: Amongst 29,420 potential users, the most regular quintile had 1.22 times the odds of initiating statin (95%CI 1.11-1.34), while the high continuity group had an odds ratio of 1.12 (95%CI 1.02-1.24). Amongst 30,408 existing users, the most regular quintile had 0.82 the hazard of non-adherence (95%CI 0.78-0.87); the high continuity group had a hazard ratio of 0.89 (95%CI 0.84-0.94). CONCLUSIONS: Regularity and continuity of care impact on medication management. It is possible that this mediates impacts on hospitalisation. Where there is a risk of unobserved confounding, potential causal pathways should be investigated.

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Factors Associated with Reinitiation of Statin Treatment in Older Patients with Peripheral Arterial Disease

et al. 2020

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Patient-Associated Characteristics Influencing the Risk for Non-Persistence with Statins in Older Patients with Peripheral Arterial Disease

Cited by 13 publications

References 44 publications

Non-Adherence to Statin Treatment in Older Patients with Peripheral Arterial Disease Depending on Persistence Status

Non-Adherence to Statin Treatment in Older Patients with Peripheral Arterial Disease Depending on Persistence Status

Regularity and Continuity of GP Contacts and Use of Statins Amongst People at Risk of Cardiovascular Events

Factors Associated with Reinitiation of Statin Treatment in Older Patients with Peripheral Arterial Disease

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