Advertisement

Central European Journal of Medicine

, Volume 8, Issue 5, pp 580–585 | Cite as

An education-behavioural intervention improves adherence to statins

  • Przemyslaw Kardas
Research Article
  • 109 Downloads

Abstract

Purpose

Effective treatment of hyperlipidemia is an important precondition for cardiovascular diseases. Unfortunately, adherence to lipid-lowering treatment is unsatisfactory. In order to improve adherence to statins, an intervention combining educational and behavioural components was tested in general practice settings.

Methods

A total of 198 outpatients with untreated hyperlipidemia were enrolled in this open-label, prospective, randomised study. Patients were prescribed simvastatin, in initial dosage of 20 mg daily, and followed for 48 weeks. Intervention group received educational counseling at each visit (that is every 8 weeks); and were also asked to adopt a routine evening activity of their choice for a reminder. Control group obtained usual care. Primary outcome measure was patient adherence, expressed as medication possession ratio (MPR).

Results

Patients’ mean age was 59.6 +/- 9.1 years. Study arms differed in their level of adherence: mean ± SD MPR was 95.4±53.7% and 81.7±31.0%, for intervention and control group, respectively (P<0.05). Patients from intervention group found a reminder activity useful in over 90% of cases.

Conclusions

Simple inexpensive educational-behavioural intervention proved to be effective in enhancing adherence to statins in hyperlipidemia. Given the health and economic consequences of non-adherence, these results may have high clinical, and practical usefulness.

Keywords

Patient adherence Statins Hyperlipidemia Education-behavioural intervention Primary prevention Secondary prevention 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    Sabate E (red). Adherence to long-term therapies: evidence for action. Geneva, World Health Organization, 2003Google Scholar
  2. [2]
    Kardas P. Compliance, Clinical Outcome, And Quality Of Life Of Patients With Stable Angina Pectoris Receiving Once Daily Betaxolol Versus Twice Daily Metoprolol: A Randomized Controlled Trial. Vas Health Risk Manag 2007;3(2): 235–242CrossRefGoogle Scholar
  3. [3]
    Kardas P. Comparison Of Once Daily Versus Twice Daily Oral Nitrates In Stable Angina Pectoris. Am J Cardiol 2004;94: 213–216PubMedCrossRefGoogle Scholar
  4. [4]
    Perreault S, Dragomir A, Blais L, et al. Impact of better adherence to statin agents in the primary prevention of coronary artery disease. Eur J Clin Pharmacol. 2009;65(10): 1013–1024PubMedCrossRefGoogle Scholar
  5. [5]
    Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction. JAMA. 2007;297(2): 177–186PubMedCrossRefGoogle Scholar
  6. [6]
    Poluzzi E, Piccinni C, Carta P et al. Cardiovascular events in statin recipients: impact of adherence to treatment in a 3-year record linkage study. Eur J Clin Pharmacol. 2011;67(4): 407–414PubMedCrossRefGoogle Scholar
  7. [7]
    Bouchard MH, Dragomir A, Blais L, Berard A, Pilon D, Perrault S. Impact of adherence to statins on coronary artery disease in primary prevention. Br J Clin Pharacol 2007;63(6): 698–708CrossRefGoogle Scholar
  8. [8]
    Ho PM, Magid DJ, Masoudi FA, McClure DL, Rumsfeld JS. Adherence to cardioprotective medications and mortality among patients with diabetes and ischemic heart disease. BMC Cardiovasc Disord. 2006; 6: 48., doi:10.1186/1471-2261-6-48PubMedCrossRefGoogle Scholar
  9. [9]
    Chapman RH, Benner JS, Petrilla AA et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med 2005;165(10): 1147–1152PubMedCrossRefGoogle Scholar
  10. [10]
    Rublee DA, Chen SY, Mardekian J, Wu N, Rao P, Boulanger L. Evaluation of cardiovascular morbidity associated with adherence to atorvastatin therapy. Am J Ther. 2012;19(1): 24–32PubMedCrossRefGoogle Scholar
  11. [11]
    Simons LA, Ortiz M, Calcino G. Long term persistence with statin therapy — experience in Australia 2006–2010. Aust Fam Physician. 2011;40(5): 319–322PubMedGoogle Scholar
  12. [12]
    McGinnis BD, Olson KL, Delate TM, Stolcpart RS. Statin adherence and mortality in patients enrolled in a secondary prevention program. Am J Manag Care. 2009;15(10): 689–695PubMedGoogle Scholar
  13. [13]
    Shalev V, Chodick G, Silber H, Kokia E, Jan J, Heymann AD. Continuation of statin treatment and all-cause mortality: a population-based cohort study. Arch Intern Med. 2009;169(3): 260–268PubMedCrossRefGoogle Scholar
  14. [14]
    Peterson AM, Takiya L, Finley R. Meta-analysis of interventions to improve drug adherence in patients with hyperlipidemia. Pharmacotherapy. 2003;23(1): 80–87PubMedCrossRefGoogle Scholar
  15. [15]
    Kardas P. Prevalence and reasons for non-adherence to hyperlipidemia treatment. Submitted to Centr Eur J Med, 2013Google Scholar
  16. [16]
    Kardas P, Lewek P, Matyjaszczyk M. Determinants of patient adherence: a review of systematic reviews. Submitted to Front Pharmacol. 2013Google Scholar
  17. [17]
    DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3): 200–209PubMedCrossRefGoogle Scholar
  18. [18]
    Konduracka E, Jozwiak J, Mastej M et al. Rozpowszechnienie i niska skutecznosc leczenia dyslipidemii w prewencji pierwotnej i wtornej choroby niedokrwiennej serca na poziomie lekarzy medycyny rodzinnej — wyniki ogolnopolskiego badania epidemiologicznego LIPIDOGRAM 2004. Przegl Lek 2008;65(12): 834–837PubMedGoogle Scholar
  19. [19]
    Grzelak-Hodor J. Brak compliance w leczeniu statynami. Puls Medycyny 19(202), 2009Google Scholar
  20. [20]
    Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008; (2): CD000011Google Scholar
  21. [21]
    Nieuwkerk PT, Nierman MC, Vissers MN, Locadia M, Greggers-Peusch P, Knape LP, Kastelein JJ, Sprangers MA, de Haes HC, Stroes ES. Intervention to Improve Adherence to Lipid-Lowering Medication and Lipid-Levels in Patients With an Increased Cardiovascular Risk. Am J Cardiol. 2012 Sep 1;110(5):666–672CrossRefGoogle Scholar
  22. [22]
    Calvert SB, Kramer JM, Anstrom KJ, Kaltenbach LA, Stafford JA, Allen LaPointe NM. Patient-focused intervention to improve long-term adherence to evidence-based medications: a randomized trial. Am Heart J. 2012; 163(4): 657–665.e1PubMedCrossRefGoogle Scholar
  23. [23]
    Eussen SR, van der Elst ME, Klungel OH, Rompelberg CJ, Garssen J, Oosterveld MH, de Boer A, de Gier JJ, Bouvy ML. A pharmaceutical care program to improve adherence to statin therapy: a randomized controlled trial. Ann Pharmacother. 2010; 44(12): 1905–1913PubMedCrossRefGoogle Scholar
  24. [24]
    Taitel M, Jiang J, Rudkin K, Ewing S, Duncan I. The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy. Patient Prefer Adherence. 2012; 6: 323–329PubMedCrossRefGoogle Scholar
  25. [25]
    Schedlbauer A, Davies P, Fahey T. Interventions to improve adherence to lipid lowering medication. Cochrane Database Syst Rev. 2010; (3): CD004371PubMedGoogle Scholar
  26. [26]
    Mengden T, Binswanger B, Spühler T, Weisser B, Vetter W. The use of self-measured blood pressure determinations in assessing dynamics of drug compliance in a study with amlodipine once a day, morning versus evening. J Hypertens. 1993; 11(12): 1403–1411PubMedCrossRefGoogle Scholar
  27. [27]
    Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 2002; 288(4): 462–467PubMedCrossRefGoogle Scholar
  28. [28]
    Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication adherence leads to lower health care use and costs despite increased drug spending. Health Aff (Millwood). 2011; 30(1): 91–99PubMedCrossRefGoogle Scholar

Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Family MedicineMedical University of LodzLodzPoland

Personalised recommendations