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Prescribing patterns, adherence and LDL-cholesterol response of type 2 diabetes patients initiating statin on low-dose versus standard-dose treatment: a descriptive study

de Vries, F. M., Voorham, J., Hak, E. & Denig, P., Jun-2016, In : International Journal of Clinical Practice. 70, 6, p. 482-492 11 p.

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  • Prescribing patterns, adherence and LDL-cholesterol response of type 2 diabetes

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AimsThe aim of this study was to describe and compare treatment modifications and discontinuation, adherence levels and response to treatment in patients with type 2 diabetes initiating on low-dose vs. standard-dose statin treatment.

MethodsA 2-year follow-up cohort study was performed using data from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database in patients with type 2 diabetes initiating statin treatment between January 2007 and December 2012. First, we determined whether there were differences in treatment modifications and discontinuation after statin initiation between patients starting on a low-dose vs. standard-dose. Second, we looked at differences in adherence and LDL-cholesterol response after 2 years follow-up between these groups.

ResultsAround 22% of patients initiated statin treatment on a dose lower than recommended. More than half of them remained on a low dose during a 2-year follow-up period, whereas less than 15% received a dose increase. Of the patients initiating on standard-dose, also more than half remained on the same treatment during this period, whereas 8% received a dose decrease without subsequent increase. Over 25% of patients starting on low-dose or standard-dose treatment discontinued treatment, often within the first 180 days after initiation or after a first treatment change. Patients on low-dose treatment had lower adherence levels and were less likely to have adequate LDL-cholesterol response compared with patients on standard-dose after 2 years follow-up.

ConclusionsCurrent patterns of statin treatment in patients with type 2 diabetes are suboptimal, with discontinuation, inadequate adherence levels and lack of treatment intensification seen in those who had inadequate LDL-cholesterol response after 2 years of follow-up. Patients starting on low-dose had more treatment modifications, discontinuation and adherence problems as compared with those starting on standard-dose treatment, which calls for a closer look at the rationale of starting patients on low-dose statin treatment.

Original languageEnglish
Pages (from-to)482-492
Number of pages11
JournalInternational Journal of Clinical Practice
Volume70
Issue number6
Publication statusPublished - Jun-2016

    Keywords

  • DENSITY-LIPOPROTEIN CHOLESTEROL, TREATMENT INTENSIFICATION, CLINICAL-PRACTICE, LIPID MANAGEMENT, GOAL ATTAINMENT, MEDICATION, THERAPY, METAANALYSIS, SAFETY, CARE
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