Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 6;2(1):13.
doi: 10.1007/s43999-023-00029-3.

Statin adherence in patients enrolled in the disease management program for coronary artery disease - comparison between patients' and general practitioners' self-reports and patient records

Babak Salam  1 , Anne Schrimpf  2 , Sebastian Münster  3 , Markus Bleckwenn  4
Affiliations

Statin adherence in patients enrolled in the disease management program for coronary artery disease - comparison between patients' and general practitioners' self-reports and patient records

Babak Salam et al. Res Health Serv Reg. .

Abstract

Introduction: Patients with coronary artery disease (CAD) should take a statin daily for secondary prevention. However, statin adherence in patients with CAD is low. This study investigated the proportion of adherent patients enrolled in the disease management program for CAD (DMP-CAD). Adherence was examined by comparing patients' self-reports, general practitioners' (GPs) self-reports, and prescription data.

Methods: Between October 2019 and March 2020, all patients enrolled in the DMP-CAD in three GP practices in Germany were invited to participate in the study. Participants completed a questionnaire on the tolerability of statins. Further, prescription data from patient records, low-density lipoprotein (LDL) levels, and GPs' assessment of statin adherence were examined. The Medication Possession Ratio (MPR) served as a measurement tool for adherence.

Results: Seventy-four patients were included. MPR showed high statin adherence for most patients (83.8%). However, GPs did not reliably identify non-adherence in their patients. Generally, the mean LDL values were above the guideline recommendations (97.7 ± 27.9 mg/dl), with higher values in the non-adherent (123.6 ± 42 mg/dl) than in the adherent group (93.1 ± 22 mg/dl). Non-adherent patients were more likely to be employed (41.7% vs. 11.3%).

Discussion: Patients in this study showed high statin adherence. However, the LDL target value was often not reached. Therefore, GPs should take advantage of the good adherence of their patients and try to lower LDL levels by adjusting the dosage and/or changing the statin prescribed. Future studies should investigate typical characteristics of non-adherent patients in DMP-CAD so that GPs can target these patient groups and improve their adherence.

Keywords: Adherence; Coronary heart disease; Disease management program; General practitioner.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Differences in most recent LDL level (mg/dl) between adherent and non-adherent patients with CAD
See this image and copyright information in PMC

References

    1. Bundesärztekammer (2019) National health care guideline: chronic CHD (Long version). Bundesärztekammer, Berlin: äzq
    1. Mach F (2019) 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 41(1):111–18810.1093/eurheartj/ehz455 - DOI - PubMed
    1. Newby L, Califf R (2006) Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circulation 113(2):203–212 10.1161/CIRCULATIONAHA.105.505636 - DOI - PubMed
    1. Kamal-Bahl S, Burke T, Watson D, Wentworth C (2007) Discontinuation of lipid modifying drugs among commercially insured United States patients in recent clinical practice. Am J Cardiol 99(4):530–534 10.1016/j.amjcard.2006.08.063 - DOI - PubMed
    1. LaRosa J, Grundy S (2005) Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 352(14):1425–1435 10.1056/NEJMoa050461 - DOI - PubMed

LinkOut - more resources