Patient Preference and Adherence (Dec 2019)
Adherence to Statin Therapy and Attainment of LDL Cholesterol Goal Among Patients with Type 2 Diabetes and Dyslipidemia
Abstract
Monira Alwhaibi,1,2 Maha Altoaimi,3 Yazed AlRuthia,1,4 Abdulkarim M Meraya,5,6 Bander Balkhi,1,2 Ahmed Aldemerdash,1 Hadeel Alkofide,1 Tariq M Alhawassi,1,2 Abdulmajeed Alqasoumi,3 Khalid M Kamal7 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 2Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia; 4Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 5Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia; 6Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia; 7Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USACorrespondence: Monira AlwhaibiDepartment of Clinical Pharmacy, King Saud University, College of Pharmacy, Riyadh 11149, Saudi ArabiaTel +966 535384152Email [email protected]: Statins are widely utilized antidyslipidemics with a proven track record of safety and efficacy. However, the efficacy of these therapeutic agents hinges on patients’ adherence to their prescribed statins.Objective: The primary objectives of this study were to examine the relationship between adherence to prescribed statins and its impact on the low-density lipoprotein (LDL) level, and to explore the factors that influence patient adherence to statins among patients with diabetes and dyslipidemia.Methods: This was a retrospective, cross-sectional study using the electronic health records data of adults (≥18 years) with type 2 diabetes and dyslipidemia visiting outpatient clinics at a university-affiliated tertiary care center. Adherence to statin therapy was estimated using the proportion of days covered (PDC). Patients with diabetes were considered adherent to statins if they had a PDC of ≥80%. Treatment success was considered if the LDL level of < 2.6 mmol/L.Results: Out of 10,226 of patients with diabetes, 1532 met the inclusion criteria and were included in the study. Seventy-nine percent of the patients with diabetes were on atorvastatin and 21% were on simvastatin. The vast majority of the patients with diabetes (77%) were considered adherent and about 42% achieved LDL-cholesterol goal < 2.6 mmol/L. No association between adherence to statin therapy and LDL goal attainment was observed. Women had lower odds of being adherent to statin therapy (AOR=0.66, 95% CI: 0.49–0.87) compared to men. Further, young adults (18–44 years) had lower odds of being adherent to statin therapy (AOR=0.58, 95% CI: 0.32–0.97) compared to older adults (age>65 years).Conclusion: The findings of this study highlight the need to examine the impact of adherence to statins on healthcare services utilization due to different complications of uncontrolled dyslipidemia.Keywords: statins, adherence, dyslipidemia, diabetes, low-density lipoprotein cholesterol
