Objectives: To evaluate adherence, discontinuation, and persistence to high-intensity statin in comparison to moderate and low-intensity in Scotland.
Methods: Retrospective cohort study using linked health records. The study population included patients (≥ 18 years) initiated on statins between January 2010 and December 2015. Statin treatment was stratified into high, moderate, and low-intensity based on the current National Institute for Health and Care Excellence classifications. Treatment discontinuation and persistence were evaluated using the refill-gap and anniversary methods, respectively; adherence was assessed by calculating the proportion of days covered (PDC).
Results: A total of 73,716 patients (mean age 62 years [SD 12.6]) initiated statins during the study period: high-intensity n=7,163 (9.7%), moderate-intensity n=65,125 (88.3%), and low-intensity n=1,428 (1.9%). High-intensity therapy was more common among males (10.7%) than females (8.6%), and most common (17.1%) in the youngest age group (18 – 24 years). The majority of patients initiating high-intensity treatment received either atorvastatin 20mg (43.1%) or 40mg (32.3%), while 22.8% received atorvastatin 80mg. Crude discontinuation rates (50.9% high-intensity versus 75.5% low-intensity) and 1-year persistence (74.7% high-intensity versus 53.1% low-intensity) differed significantly between intensity levels; crude adherence (PDC ≥ 80%) was highest among high-intensity patients with 63.7%, compared to 51.6% and 40.5% in moderate and low-intensity, respectively.
Conclusion: Increasing the intensity of statin therapy does not seem to negatively impact adherence and persistence to treatment, although findings could be due to confounders (e.g. primary versus secondary prevention) and/or the low proportion of patients using the recommended high dose statin. Further analysis is ongoing to adjust for confounders, and to evaluate clinical outcomes associated with high-intensity statin therapy.
|Number of pages||2|
|Publication status||Published - 26 Aug 2018|
|Event||34th International Conference on Pharmacoepidemiology and Therapeutic Risk Management - The Prague Congress Centre, Prague, Czech Republic|
Duration: 22 Aug 2018 → 26 Aug 2018
|Conference||34th International Conference on Pharmacoepidemiology and Therapeutic Risk Management|
|Period||22/08/18 → 26/08/18|
- high-intensity statin therapy
- cardiovascular disease