Predictors of first-year nonadherence and discontinuation of statins among older adults: a retrospective cohort study: Br J Clin Pharmacol
Research output: Contribution to journal › Journal article › Research › peer-review
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 language | English |
---|---|
Journal | British Journal of Clinical Pharmacology |
Volume | 85 |
Pages (from-to) | 227-235 |
Number of pages | 9 |
ISSN | 1365-2125 |
DOIs | |
Publication status | Published - 2019 |
Externally published | Yes |
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.
ID: 225665107