Abstract 16924: Adherence and Persistence to Statin Therapy in a Veteran Population
Introduction: A relative cardiovascular risk reduction of 25-35% has been reported in patients that have started statins for elevated cholesterol; yet many patients fail to consistently take these medications as directed. Our study evaluated factors that impact adherence to and persistence with statin therapy.
Methods: This retrospective study analyzed data extracted from a VA database encompassing 6 facilities in Northern California, Northern Nevada and Hawaii for patients newly prescribed statin medication between July 1, 2007 and December 31, 2012. Patient demographics, co-morbidities, prescription record information, and time on therapy were collected. Adherence to statin therapy was determined using the mean possession ratio (MPR), calculated as the total days’ supply of medication dispensed divided by the total number of days in the intended treatment period. Persistence was defined as whether a patient continued to refill their statin prescription, with non-persistence occurring when a given patient did not refill their statin for a period of > 135 days.
Results: Of 37,214 patients, overall adherence to statins was reflected by a mean MPR of 0.867. Approximately 44% of patients continued to be persistent on statin therapy after 675 days. Patients prescribed pravastatin, lovastatin, rosuvastatin, and those who took more than 1 different statin during the follow-up period had statistically significant higher rates of adherence than those prescribed simvastatin. Patients 18 - 70 had an overall mean MPR < 0.8 (P<0.013), considered non-adherent; those ages 71 to 80 years were adherent with an overall mean MPR ≤ 0.8 (P<0.001). The overall mean MPR progressively increased with age groups from age 18-30 to 71-80 years of age. Using multiple logistic regression analysis, PTSD, ischemic heart disease, and hyperlipidemia were comorbidities associated with non-adherence.
Conclusions: In Veterans, statin adherence was excellent. Certain populations may benefit from interventions targeted at improving adherence to statins including younger Veterans (age 18-60), those prescribed simvastatin, and those with hyperlipidemia, ischemic heart disease, and/or PTSD.
Author Disclosures: K. Morotti: None. J. Lopez: None. M. Harvey: None. V. Vaupel: None. A. Swislocki: None. D. Siegel: None.
- © 2014 by American Heart Association, Inc.