On 7 November 2007, US News & World Report posted Many Patients Stop Taking Cholesterol-Lowering Drugs, a brief account of a study to be presented today at the American Heart Association’s annual meeting in Orlando, Florida. An excerpt follows:
Even though cholesterol-lowering statin drugs are known to be effective, many patients stop taking them, and researchers say a number of factors may be to blame. In their study, researchers in Chicago analyzed a large pharmacy’s database. They found that statin discontinuation rates among more than 768,000 patients were 28 percent after three months, 41 percent after six months, and 59 percent after one year.
“We found that subjects who were on high-dose statins, paid high co-payments, or spoke Spanish were significantly more likely to discontinue,” said the investigators at Radiant Research Inc. Patients who used the Internet, had heart disease or high blood pressure were significantly less likely to stop taking statins.
Commentary
Once again, a study of adherence to a long term medication regimen – a study with an altogether impressive population of 768,000 patients – has produced results that were all too predictable: discontinuation rates of “28 percent after three months, 41 percent after six months, and 59 percent after one year.”
Yet, despite hundreds, if not thousands, of clinical trials with similar findings, new articles continue to appear in the medical and lay press headlining the fact that many and perhaps even most individuals do not follow the course of treatment prescribed for them despite solid evidence that it works.
Of course, my conspicuously idiosyncratic reaction to this observation is that these conspicuously disappointing compliance findings are the conspicuously reliable result of the inherent conceptual flaws in our thinking about compliance, AKA adherence, AKA concordance, … .
But if I can’t sell that – which is becoming conspicuously obvious – I suggest those of us who work in the field (and therefore should, at least, know better) discourage the idea that noncompliance with diabetic regimens, inhalers, low-salt diets, medication, and other prescribed treatment is in any way surprising and point out that 50% noncompliance with treatments such as long-term medication is the expectation, not the exception.
1 response so far ↓
1 Alex Sicre // Nov 8, 2007 at 11:32 am
Where is Robocop when you need him? I don’t read as many medical journals as you, but why are their finding always the same? High co-payments, improper education and side effects are the reasons – wow that’s a shocker. What is the effect of the internet on medication adherence? Are the patients looking up what could happen to them if they stop taking their medication – like death? I like the Bart visual!