Ofori-Asenso, R and Jakhu, A and Zomer, E and Curtis, AJ and Korhonen, MJ and Nelson, M and Gambhir, M and Tonkin, A and Liew, D and Zoungas, S, Adherence and persistence among statin users aged 65 years and over: A systematic review and meta-analysis, Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 73, (6) pp. 813-819. ISSN 1079-5006 (2018) [Refereed Article]
Copyright 2017 The Authors
Methods: As part of a broader systematic review, we searched Medline, Embase, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects, CENTRAL and the National Health Service Economic Evaluation Database through December 2016 for English articles reporting adherence and/or persistence among older statin users. Data were analysed via descriptive methods and meta-analysis using random-effect modeling.
Results: Data from > 3 million older statin users in 82 studies conducted in over 40 countries were analysed. At 1-year follow up, 59.7% (primary prevention 47.9%; secondary prevention 62.3%) of users were adherent (medication possession ratio [MPR] or proportion of days covered [PDC] ≥ 80%). For both primary and secondary prevention subjects, 1-year adherence was worse among individuals aged > 75 than those aged 65-75 years. At 3 and ≥ 10 years, 55.3% and 28.4% of users were adherent, respectively. The proportion of users persistent at 1-year was 76.7% (primary prevention 76.0%; secondary prevention 82.6%). Additionally, 68.1% and 61.2% of users were persistent at 2 and 4 years, respectively. Among new statin users, 48.2% were non-adherent and 23.9% discontinued within the first year. The proportion of statin users who were adherent based on self-report was 85.5%.
Conclusions: There is poor short and long term adherence and persistence among older statin users. Strategies to improve adherence and reduce discontinuation are needed if the intended cardiovascular benefits of statin treatment are to be realised.
|Item Type:||Refereed Article|
|Keywords:||HMG-CoA reductase inhibitors, discontinuation, cardiovascular disease prevention|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|Author:||Nelson, M (Professor Mark Nelson)|
|Year Published:||2018 (online first 2017)|
|Web of Science® Times Cited:||2|
|Deposited By:||Menzies Institute for Medical Research|
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