Original Research Article


, Volume 22, Supplement 3, pp 13-23

First online:

Follow-up lipid tests and physician visits are associated with improved adherence to statin therapy

  • Joshua S. BennerAffiliated withValueMedics Research, LLC Email author 
  • , Jonothan C. TierceAffiliated withValueMedics Research, LLC
  • , Christie M. BallantyneAffiliated withBaylor College of Medicine
  • , Cheryl PrasadAffiliated withValueMedics Research, LLC
  • , Michael F. BullanoAffiliated withHealth Core, Inc.
  • , Vincent J. WilleyAffiliated withHealth Core, Inc.
  • , John ErbeyAffiliated withSchering-Plough Pharmaceuticals
  • , David S. SuganoAffiliated withSchering-Plough Pharmaceuticals

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Introduction and Objective: The National Cholesterol Education Program recommends regular physician follow-up and lipid testing to promote adherence with lipidlowering medications. The objective of this study was to determine whether lipid tests and physician visits after treatment initiation are indeed associated with adherence to statin therapy.

Subjects and Methods: A retrospective cohort study was conducted among 19 422 enrolees in a US managed care plan who initiated treatment with a statin between October 1999 and August 2001. Computerised pharmacy, medical and laboratory records were used to study the patterns and predictors of adherence with lipid-lowering therapy for up to 3 years. Adherence was assessed in 3-month intervals with patients considered ‘adherent’ if ≥80% of days were covered by lipid-lowering therapy.

Results: In the first 3 months, 40% of patients had follow-up lipid tests and only 21% had dyslipidaemia visits (14% had both). Those receiving such care were substantially more likely to be adherent in subsequent intervals. Compared with those without follow-up, the relative odds of adherence were 1.42 and 1.27 for patients with one or more lipid test and one or more dyslipidaemia visit, respectively (95% confidence intervals [CI] 1.33, 1.50 and 1.16, 1.39). Patients who received a followup visit and lipid test were 45% more likely to be adherent (95% CI 1.34, 1.55). Similar associations were observed when lipid tests and dyslipidaemia visits occurred later in therapy.

Conclusion: Early and frequent follow-up by physicians — especially lipid testing — was associated with improved adherence to lipid-lowering therapy. A randomised prospective study is needed to determine whether this relationship is causal.