Pdg83 Attitudes and Intention of Pharmd Students to Use Stimulants for Enhancing Academic Performance

Abstract

Objectives: To investigate the impact of statin adherence on clinical outcomes in the patients initiated with statin for primary and secondary prevention in China. Methods: Data were obtained from Tianjin Urban Employee Basic Medical Insurance database (2011)(2012)(2013)(2014)(2015). Adult patients initiated with statin (index date) with $2 prescriptions from 2012 through 2013 were included and followed for 24 months. Patients who experienced major adverse cardiovascular events (MACEs) in the initial 12-month follow-up were further excluded. Included patients were grouped into primary and secondary prevention subgroups according to whether they had cardiovascular disease or related surgery records during the prior 12-month baseline period. Patients with $0.5 of proportion of days covered (PDC) during the initial 12month follow-up were regarded as adherers. Propensity score matching (PSM) was conducted to form balanced pairs of adherers and non-adherers in primary and secondary prevention subgroups respectively. The incidence of MACEs during the 13th-24th months follow-up were compared between the matched adherers and non-adherers using Cox regression models. Results: 99,655 patients were identified, with 34.49% (65.51%) in primary (secondary) prevention subgroup. PSM selected 2,394 matched patients in primary prevention subgroup (47.37% female; mean age 52.7612.3 years), and the mean PDC were 0.6360.11 for the adherers and 0.1860.12 for non-adherers. Cox model showed that the adherers had a 62% reduced risk of MACEs compared with non-adherers in primary prevention subgroup (0.84% vs. 2.01%; adjusted HR=0.38, 95%CI, 0.18-0.80, P=0.011). Similar analyses were repeated in the secondary prevention subgroup (matched cohort: N=6,944), but no significant difference of risk of MACEs was observed between adheres and non-adheres (4.38% vs. 4.03%; adjusted HR=1.14, 95% CI, 0.91-1.44, P= 0.264). Conclusions: In patients initiated with statin for primary prevention, being adherent to statin is associated with decreased risk of adverse clinical outcomes in China. Further exploration is needed in secondary prevention group.