Statin Compliance
Patient Compliance With Statins From Bandolier1
The concluding Comment section succinctly and admirably summarizes the entire article:
In order to achieve maximum benefit from statin therapy patients need to take the drug at an appropriate dose, probably for the rest of their lives. The majority of patients for whom statins are prescribed in clinical practice either stop taking the drug altogether or take less than the prescribed dose within a year. This is likely to reduce or remove any benefit, and may even cause harm.
A non-exhaustive list of other pertinent points includes
- There is a movement of patients to different levels of adherence at different times, specifically that most patients who moved from the partially adherent group were to be found in the non-adherent group.
- Adverse effects, one of the rationales for noncompliance on which clinicians and pharmaceutical companies habitually focus, rates were found to be low in the case of statins and could account for only a small fraction of the non-adherence.
- The article notes that the studies indicate that patients not taking statins are more vulnerable to cardiovascular problems but also that other studies show that withdrawal of statins or abrupt decreases in their dosage can increase the risk of thrombotic events.
- The conclusion that most interventions have a positive effect in the short term, but to be successful in the long-term a sustained multi-factorial approach is required. A combination of patient-focused, physician-focused, and system-focused interventions works best is supplemented by a brief table of specific interventions most likely to be successful.
Commentary
As is true of most Bandolier articles, Patient Compliance With Statins provides a useful summary for clinicians and information that is clearly written and easy for most patients to understand.
Footnotes
- I do have one complaint about Bandolier’s online version: I can find no simple, direct means to determine from a given web page, such as the one that contains the article reviewed today, when the article was written [back]
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