Real-world evaluation of the impact of statin intensity on adherence and persistence to therapy: a scottish population-based study

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dc.creatorRenata Cristina Rezende Macedo do Nascimento
dc.creatorMarion Bennie
dc.creatorAmanj Kurdi
dc.creatorTanja Mueller
dc.creatorBrian Godman
dc.creatorSean Macbride Stewart
dc.creatorSimon Hurding
dc.creatorFrancisco Assis Acurcio
dc.creatorAugusto Afonso Guerra Júnior
dc.creatorJuliana Alvares Teodoro
dc.creatorAlec Morton
dc.date.accessioned2023-07-18T16:49:21Z
dc.date.accessioned2025-09-09T01:06:54Z
dc.date.available2023-07-18T16:49:21Z
dc.date.issued2020
dc.identifier.doihttps://doi.org/10.1111/bcp.14333
dc.identifier.issn0306-5251
dc.identifier.urihttps://hdl.handle.net/1843/56589
dc.languagepor
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofBritish Journal of Clinical Pharmacology
dc.rightsAcesso Aberto
dc.subjectSistema cardiovascular - Doenças
dc.subjectEscócia
dc.subjectEstatinas (Agentes cardiovasculares)
dc.subject.otherCardiovascular disease
dc.subject.otherDrug utilisation
dc.subject.otherHigh-intensity therapy
dc.subject.otherMedication adherence
dc.subject.otherScotland
dc.subject.otherStatins
dc.titleReal-world evaluation of the impact of statin intensity on adherence and persistence to therapy: a scottish population-based study
dc.typeArtigo de periódico
local.citation.epage2361
local.citation.spage2349
local.description.resumoAim: To assess associations between statin intensity and adherence, persistence and discontinuation of statin therapy in Scotland. Method: Retrospective cohort study, using linked electronic health records covering a period from January 2009 to December 2016. The study cohort included adult patients (≥18 years) newly initiating statins within Greater Glasgow and Clyde, Scotland. Study outcomes comprised adherence, discontinuation and persistence to treatment, stratified by three exposure groups (high, moderate and low intensity). Discontinuation and persistence were calculated using the refill-gap and anniversary methods, respectively. Proportion of days covered (PDC) was used as a proxy for adherence. Kaplan-Meier survival curves and Cox proportional hazard models were used to evaluate discontinuation, and associations between adherence/persistence and statin intensity were assessed using logistic regression. Results: A total of 73 716 patients with a mean age of 61.4 ± 12.6 years were included; the majority (88.3%) received moderate intensity statins. Discontinuation rates differed between intensity levels, with high-intensity patients less likely to discontinue treatment compared to those on moderate intensity (prior cardiovascular disease [CVD]: HR 0.43 [95% CI 0.34-0.55]; no prior CVD: 0.80 [0.74-0.86]). Persistence declined over time, and high-intensity patients had the highest persistence rates. Overall, 52.6% of patients were adherent to treatment (PDC ≥ 80%), but adherence was considerably higher among high-intensity patients (63.7%). Conclusion: High-intensity statins were associated with better persistence and adherence to treatment, but overall long-term persistence and adherence remain a challenge, particularly among patients without prior CVD. This needs addressing
local.identifier.orcidhttps://orcid.org/0000-0001-6410-9716
local.identifier.orcidhttps://orcid.org/0000-0002-4046-629X
local.identifier.orcidhttps://orcid.org/0000-0001-5036-1988
local.identifier.orcidhttps://orcid.org/0000-0002-0418-4789
local.identifier.orcidhttps://orcid.org/0000-0001-6539-6972
local.identifier.orcidhttps://orcid.org/0000-0002-2553-5939
local.identifier.orcidhttps://orcid.org/0000-0002-5880-5261
local.identifier.orcidhttps://orcid.org/0000-0001-5256-0577
local.identifier.orcidhttps://orcid.org/0000-0002-0210-0721
local.identifier.orcidhttps://orcid.org/0000-0003-3803-8517
local.publisher.countryBrasil
local.publisher.departmentFAR - DEPARTAMENTO DE FARMÁCIA SOCIAL
local.publisher.initialsUFMG
local.url.externahttps://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.14333

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