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. 2025 Jul 24.
doi: 10.1002/bcp.70170. Online ahead of print.

Medication persistence trajectories among individuals prescribed lipid-lowering therapy in primary care settings: A retrospective cohort study

Zhomart Orman  1 , Jia Wei Koh  1   2 , Caroline Trin  1 , Zanfina Ademi  1   2 , Ella Zomer  1 , Danielle Berkovic  1 , Jenni Ilomaki  2 , J Simon Bell  2 , Danny Liew  1   3 , Christopher M Reid  1   4 , Sean Lybrand  1 , Brittany Schoeninger  5 , Stella Talic  1
Affiliations

Medication persistence trajectories among individuals prescribed lipid-lowering therapy in primary care settings: A retrospective cohort study

Zhomart Orman et al. Br J Clin Pharmacol. .

Abstract

Aims: This study aimed to identify distinct trajectories of lipid-modifying medication (LMM) persistence over time and to explore characteristics associated with each pattern.

Methods: Using primary care data from IQVIA, we conducted a retrospective cohort study of adults prescribed LMMs between January 2015 and December 2017, with 5 years of follow-up. Persistence was defined as ≥1 prescription every 6 months. Group-based trajectory modelling identified medication persistence patterns; characteristics were compared using 1-way ANOVA and chi-squared tests.

Results: Among 51 504 individuals (mean age 62 years, 53% male), 4 distinct trajectories were identified: persistent use (PU, 20%), gradual decline (10%), rapid decline (29%) and early discontinuation (41%). Compared to those who discontinued early, individuals in the rapid decline, gradual decline and PU groups were older by 1.18 (95% confidence interval: 0.82-1.55), 2.61 (2.08-3.13) and 3.71 (3.30-4.12) years, respectively. Persistent users were more likely to have cardiovascular risk factors: a higher proportion of smokers (44.4 vs. 39.6%), elevated systolic blood pressure (≥140 mmHg: 36.9 vs. 32.9%) and reduced renal function (estimated glomerular filtration rate >45 mL/min/m2: 14.4 vs. 11.7%) compared to those who discontinued LMMs early. In contrast, the early discontinuation group had a greater proportion of metropolitan residents (76.1 vs. 69.2%) and individuals with elevated total cholesterol ratios (>4: 60.8 vs. 53.8%) than the PU group.

Conclusions: Distinct profiles across trajectories highlight the need for tailored interventions to improve long-term medication use, particularly among younger, healthier individuals and those residing in metropolitan areas.

Keywords: group‐based trajectory analyses; lipid‐modifying medications; medication persistence; primary care; primary prevention; statins.

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References

REFERENCES

    1. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2019;140(11):e563‐e595. doi:10.1161/CIR.0000000000000677
    1. Chew DP, Scott IA, Cullen L, et al. National Heart Foundation of Australia & cardiac Society of Australia and new Zealand: Australian clinical guidelines for the Management of Acute Coronary Syndromes 2016. Heart Lung Circ. 2016;25(9):895‐951. doi:10.1016/j.hlc.2016.06.789
    1. Chou R, Cantor A, Dana T, et al. Statin use for the primary prevention of cardiovascular disease in adults: updated evidence report and systematic review for the US preventive services task force. Jama. 2022;328(8):754‐771. doi:10.1001/jama.2022.12138
    1. National Vascular Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk. 2023 https://www.heartfoundation.org.au/Bundles/For-Professionals/Guideline-f...
    1. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227‐3337. doi:10.1093/eurheartj/ehab484

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