Identifying Patient Perceptions and Attitudes Regarding statin-associated Diabetes Mellitus: A mixed-methods Study

Abstract

Aim: The aims of this study were to explore factors that influence initiation and continuation of statin therapy. Patients & methods: Mixed-method design employed with 73 patients completing surveys and 14 patients participating in semi-structured interviews. Results: When lower total cholesterol is achieved, patients’ views are favorable while views of statin therapy diminish among those with higher total cholesterol values. All patients are concerned with adverse events including the potential for developing diabetes. However, overall patients believe the benefits of statins outweigh the risk of diabetes. Conclusion: Barriers remain that prevent patients from achieving cholesterol goals and maintaining or initiating statin therapy. Effective strategies to provide accurate information about the risks and benefits of statin therapy, and implementation of shared decision-making to improve medication adherence and persistence are needed.

Plain language summary

The statin medications are commonly prescribed agents used to lower cholesterol and prevent cardiovascular events, such as heart attacks. Although these medications are prescribed often, researchers and clinicians have limited understanding regarding the influences involving patients’ decision to start or stop a statin. This study was conducted to gain insight on patients’ beliefs and attitudes involving statin therapy. We observed that when patients’ had lower cholesterol values, favorable views of statins were more common, while views became less favorable when cholesterol levels were higher. All patients were concerned about statin-associated side effects; but overall believed that the benefits of statins outweighed the risks. It is essential that patients’ are provided accurate information from their healthcare team regarding the advantages and disadvantages of statin therapy. Such discussions may allow patients to make more informed decisions and help with continuing a statin long term.

Keywords:

• cardiovascular disease
• lipids
• mixed methods
• new onset diabetes mellitus
• patient attitudes
• statins

Author contributions

JM Backes and CA Gibson designed the overall study. CA Gibson and RR Mount executed the interventions and contributed to data collection. CA Gibson and J Lee analyzed the data and participated in developing tables and figures. All authors participated in drafting and revising the manuscript. All authors reviewed and approved of the final version.

Financial & competing interests disclosure

This research was funded by a grant from Kowa Pharmaceuticals. JM Backes: Research grant: Kowa. CA Gibson, RR Mount, and J Lee have no interests to declare. The authors have no other 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 apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval and have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Data sharing statement

Data are available upon reasonable request.