Statin adherence and treatment LDL-cholesterol response in type 2 diabetes patientsDe Vries, D., Voorham, J., Hak, E. & Denig, P., 1-Oct-2014, In : Pharmacoepidemiology and Drug Safety. 23, S1, p. 322-323 2 p.
Research output: Contribution to journal › Meeting Abstract › Academic
Background: In clinical practice statins are not optimally used and lipid targets are not achieved in at least a third of the patients. This lack of treatment response could be due to undertreatment (low-dose statin) and low adherence to treatment. Objectives: To determine the relationship between statin dose, adherence and LDL-cholesterol response in new statin users. Methods: This cohort study was performed using data from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database. The relation between adherence and LDL-cholesterol response was assessed during the first year of treatment with a standard-dose statin using linear regression, adjusting for covariates. The modifying effect of low-dose versus standard-dose was assessed in a propensity-score matched cohort. Adherence was measured as the medication possession ratio (MPR). Results: In total 22% of the 8,282 new statin users started on a low-dose, around 80% of them stayed on this low-dose during the first year of treatment. These patients did not differ in LDL-cholesterol level and macro- and microvascular comorbidity compared to patients on standard-dose treatment. The mean adherence was around 80%in both groups. The effect of adherence on LDL-cholesterol response, measured in 1,797 patients, was dependent on the baseline LDL-cholesterol level. With an average baseline LDL-cholesterol level of 3.8mmol/l, an increase in adherence of 10% resulted in an estimated decrease in LDL-cholesterol of 0.2mmol/l. In the matched sample of 950 patients, treatment dose modified the association between adherence and LDL outcome. For adherence rates >80% there was a significant difference in effectiveness of low-dose versus standard-dose statin treatment. Conclusions: For patients with poor adherence rates (MPR
|Number of pages||2|
|Journal||Pharmacoepidemiology and Drug Safety|
|Publication status||Published - 1-Oct-2014|
- statin (protein), low density lipoprotein cholesterol, low density lipoprotein, lipid, hydroxymethylglutaryl coenzyme A reductase inhibitor, non insulin dependent diabetes mellitus, human, diabetic patient, pharmacoepidemiology, risk management, patient, low drug dose, data base, cohort analysis, medication compliance, treatment response, patient compliance, propensity score, linear regression analysis, drug therapy, comorbidity, clinical practice