Overcoming Barriers to Statin Adherence

Arden Bui, PharmD Candidate 2021; Juwon Kwon, PharmD; Jennifer Kim, PharmD, BCPS, BCACP, CPP; Austin Lucas, PharmD

Disclosures

US Pharmacist. 2019;44(6):19-22. 

In This Article

Abstract and Introduction

Abstract

Despite the increased use of statins as a result of expanding indications and guideline recommendations, lack of adherence remains a pervasive issue in medication management. Nonadherence to statins can lead to poor health outcomes, including cardiovascular disease–related emergency department visits, hospitalizations, healthcare costs, and mortality. Medication adherence is multifactorial, and a comprehensive approach is essential for optimization. Potential barriers to statin adherence include costs and adverse effects; interventions that pharmacists can employ include counseling and simplifying regimens.

Introduction

Cardiovascular disease (CVD) is the leading cause of death globally. In 2016, an estimated 17.9 million people died from CVD, accounting for 31% of global deaths, of which 85% were due to myocardial infarction (MI) and stroke.[1] Statins, as 3-hydroxy-3-methylglutarylcoenzyme A reductase inhibitors are known, are commonly prescribed medications that are pivotal for preventing CVD and related events.[2]

Medication adherence directly influences the extent to which statins prevent CVD events, including mortality (Table 1).[2–7] Poor statin adherence can also increase CVD related emergency department visits, hospitalizations, and healthcare costs.[6,7] A 10% reduction in statin-medication possession ratio is associated with a 5% increased risk for CVD-related hospitalizations.[7] Furthermore, nonadherence over 1 year is associated with a $400 to $900 per patient higher total healthcare cost in the subsequent 18 months. Despite well-documented benefits, statins are underused, and adherence remains suboptimal. Approximately 50% of patients discontinue statin therapy within 1 year, and adherence decreases over time.[4,6]

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