Study: Lifestyle factors play a role in statin med adherence

Lifestyle factors may help predict whether people will adhere to statin therapy for high cholesterol, according to a study published in CMAJ (Canadian Medical Association Journal).

Heli Halava, departments of public health and pharmacology, University of Turku, Turku, Finland, and colleagues studied data on 11,949 people involved in the Finnish Public Sector Study who had started statin therapy after the survey, between 1998 and 2010. Of these, 928 responded to a survey about health status and lifestyle factors. The researchers linked the survey data with data in national health registers.

“We used prescription dispensing data to determine participants’ nonadherence to statin therapy during the first year of treatment [defined as <80% of days covered by filled prescriptions],” Halava explained. “We estimated the association of several lifestyle factors with nonadherence, after adjusting for sex, age and year of statin initiation.”

The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n=6458), 3,171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n=2,827), 1,155 (40.9%) were nonadherent.

Among patients with cardiovascular diseases or diabetes those with high mean alcohol consumption, extreme drinking occasions or clustering of 3 to 4 lifestyle risks may be at high risk of nonadherence, the authors concluded.

“The benefits of medication may not always be obvious for a hypercholesterolemic patient with a symptomless condition,” Halava explained. “The nonadherence to lipid-lowering therapy is associated with an increased risk of adverse cardiovascular outcomes. Identifying factors that are critical to adherence is therefore a major public health challenge.”

“Easily detectable predictors of nonadherence to long-term drug treatment are lacking,” Halava said. “We investigated the association between lifestyle factors and nonadherence to statin therapy among patients with and without cardiovascular comorbidities.”