Pharmacy-based predictors of non-persistence with and non-adherence to statin treatment among patients on oral diabetes medication in the Netherlands

AIMS: To evaluate statin non-persistence and non-adherence as discrete processes in diabetes patients, and identify pharmacy-based predictors of these processes in the first year after statin initiation. METHODS: We conducted a retrospective cohort study of statin initiators using a pharmacy database. Persistence and adherence were measured in the first, second and third year. Non-persistence was defined as a gap >180 days. Non-adherence was calculated in persistent patients and defined as a medication possession ratio <80%. Cox regression hazard ratios (HRs) and logistic regression odds... Mehr ...

Verfasser: Alfian, Sofa D
Worawutputtapong, Pawida
Schuiling-Veninga, Catharina C M
van der Schans, Jurjen
Bos, JH
Hak, Eelko
Denig, Petra
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: Alfian , S D , Worawutputtapong , P , Schuiling-Veninga , C C M , van der Schans , J , Bos , JH , Hak , E & Denig , P 2018 , ' Pharmacy-based predictors of non-persistence with and non-adherence to statin treatment among patients on oral diabetes medication in the Netherlands ' , Current Medical Research and Opinion , vol. 34 , no. 6 , pp. 1013-1019 . https://doi.org/10.1080/03007995.2017.1417242
Schlagwörter: Medication adherence / diabetes mellitus / hydroxymethylglutaryl-CoA reductase inhibitors / CHOLESTEROL RESPONSE / ADHERENCE / DISCONTINUATION / THERAPY / COHORT / CARE / MELLITUS / OUTCOMES / IADB
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29190422
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/1f7e9727-5983-47b1-929a-f976e3e86b50

AIMS: To evaluate statin non-persistence and non-adherence as discrete processes in diabetes patients, and identify pharmacy-based predictors of these processes in the first year after statin initiation. METHODS: We conducted a retrospective cohort study of statin initiators using a pharmacy database. Persistence and adherence were measured in the first, second and third year. Non-persistence was defined as a gap >180 days. Non-adherence was calculated in persistent patients and defined as a medication possession ratio <80%. Cox regression hazard ratios (HRs) and logistic regression odds ratios (ORs) were assessed for sociodemographic and medication-related factors as possible predictors. RESULTS: Of 12,741 initiators, 20.0% were non-persistent in the first year, while 9.0% and 7.5% were non-persistent in the second and third years. Non-adherence in persistent patients increased from 13.4% in the first to 15.6% and 18.1% in the second and third years. Predictors of non-persistence were female gender (HR: 1.10; 95% CI: 1.01-1.19), older age (HR: 1.52; 95% CI: 1.31-1.75), primary prevention (HR: 1.10; 95% CI: 1.00-1.20), initiating on low dose (HR: 1.44; 95% CI: 1.07-1.94) or standard dose (HR: 1.56; 95% CI: 1.16-2.10), and no cardiovascular co-medication (HR: 1.19; 95% CI: 1.07-1.33), while patients with four or more other medications were more likely to be persistent. Age <50 years (OR: 1.47; 95% CI: 1.22-1.77), low socioeconomic status (OR: 1.27; 95% CI: 1.12-1.45) and primary prevention (OR: 1.21; 95% CI: 1.07-1.38) were predictors of non-adherence, while females were more likely to be adherent (OR: 0.87; 95% CI: 0.77-0.98). CONCLUSION: Non-persistence was the foremost problem in the first year after statin initiation, while non-adherence in persistent patients increased in the second and third years. Pharmacy-based predictors of statin non-persistence were different from predictors of non-adherence among persistent patients.