Statin adherence in patients with high cardiovascular risk: a cross-sectional study

ABSTRACT

Objectives

Statin adherence is an essential problem although lifetime medication is recommended especially in patients with high cardiovascular risk. The importance of perceived risk as a predictor of adherence among cardiology patients has not been fully explored. This study aimed to test the importance of perceived risk as a predictor of statin adherence amongst hypercholesterolemic patients to identify predictors associated with poor adherence.

Methods

This cross-sectional study was conducted at cardiology outpatient clinics of the University hospital in Ankara, Turkey. A total of 327 consecutive patients with high CV risk were recruited. Self-reported Morisky Green Levine Medication Adherence Scale was used to assess statin adherence.

Results

Of the patients studied, 34.5% had concerns about side effects. Also, the mean age was 63.85 ± 11.29 years, 66.1% were men, 32.4% applied non-drug alternative therapies, 53.2% had a Mediterranean-style diet and 20.8% checked their lipid values irregularly. Participants reported 50.2% high, 30% moderate, and 19.9% low statin medication adherence. Low-density lipoprotein cholesterol (LDL-C), Total Cholesterol (TC), Triglyceride (TG) and high-density lipoprotein (HDL) control rates were 44.6%, 74.3%, 61.5% and 41.6%. On multiple logistic regression, concern about side effects was associated with a statistically significant quadruple elevation of odds of non-adherence. Also, being male, former smokers, not having complementary interventions, having regular visits, being educated for more than 5 years, having low depressive symptom scores, living in a rural, being never or former smokers, employee were significant predictors of high medication adherence scores.

Conclusion

Approximately half of the patients reported high medication adherence. Proper strategies to improve adherence would include patient education efforts focused on patients with concerns about side effects and those who are female, less educated, current smokers, interested in complementary interventions, have irregular follow-up visits, and have depressive symptoms. Brief medication adherence scales may facilitate the assessment of patients’ adherence.

KEYWORDS:

• Statin
• medication adherence
• cardiovascular prevention
• risk factors

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

None.

Author contributions

Conceptualization: Yusuf Cetin Doganer, Umit Aydogan, Uygar Cagdas Yuksel; Methodology: Yusuf Cetin Doganer, Umit Aydogan, Umit Kaplan, Suat Gormel, James Edwin Rohrer; Formal analysis and investigation: Yusuf Cetin Doganer, Umit Kaplan, Suat Gormel; Writing - original draft preparation: Yusuf Cetin Doganer, Umit Aydogan, Umit Kaplan, James Edwin Rohrer; Writing - review and editing: Umit Aydogan, Suat Gormel, James Edwin Rohrer, Uygar Cagdas Yuksel; Supervision: James Edwin Rohrer, Uygar Cagdas Yuksel

Additional information

Funding

This paper was not funded.