Predictors of first-year nonadherence and discontinuation of statins among older adults: a retrospective cohort study: Br J Clin Pharmacol

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  • R. Ofori-Asenso
  • J. Ilomaki
  • M. Tacey
  • S. Si
  • A. J. Curtis
  • E. Zomer
  • J. S. Bell
  • S. Zoungas
  • D. Liew
AIMS: The aim of this study was to examine the level of and predictors of statin nonadherence and discontinuation among older adults. METHODS: Among 22 340 Australians aged >/=65 years who initiated statin therapy from January 2014 to December 2015, we estimated the first-year nonadherence (proportion of days covered [PDC] /=90 days without statin coverage) rates. Predictors of nonadherence and discontinuation were examined via multivariable logistic regression. Analyses were performed separately for general beneficiaries (with a higher co-payment; n = 4841) and concessional beneficiaries (with a lower co-payment; n = 17 499). RESULTS: During the one-year follow-up, 55.1% were nonadherent (concessional 52.6%; general beneficiaries 64.2%) and 44.7% discontinued statins (concessional 43.1%; general beneficiaries 50.4%). Among concessional beneficiaries, those aged 75-84 years and >/=85 years were more likely to discontinue than people aged 65-74 years (odds ratio 1.11, 95% confidence interval 1.04-1.19 and 1.38, 1.23-1.54, respectively). Diabetes was associated with an increased likelihood of nonadherence and discontinuation, while hypertension, angina and congestive heart failure were associated with a lower likelihood of nonadherence and discontinuation. Anxiety was associated with an increased likelihood of discontinuation, but polypharmacy (concurrent use of five or more drugs) was associated with a lower likelihood of nonadherence and discontinuation. Statin initiation by a general medical practitioner was associated with both increased likelihood of nonadherence and discontinuation. Similar predictors of nonadherence and discontinuation were identified for the general beneficiaries. CONCLUSIONS: Among older adults prescribed statins, first-year nonadherence and discontinuation are high. Specific population subgroups such as people aged >/=85 years, those with diabetes or anxiety may require additional attention to improve statin adherence.
Original languageEnglish
JournalBritish Journal of Clinical Pharmacology
Volume85
Pages (from-to)227-235
Number of pages9
ISSN1365-2125
DOIs
Publication statusPublished - 2019
Externally publishedYes

Bibliographical note

M1 - 1

Ofori-Asenso, Richard Ilomaki, Jenni Tacey, Mark Si, Si Curtis, Andrea J Zomer, Ella Bell, J Simon Zoungas, Sophia Liew, Danny eng England 2018/11/08 06:00 Br J Clin Pharmacol. 2019 Jan;85(1):227-235. doi: 10.1111/bcp.13797. Epub 2018 Nov 8.

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