OBJECTIVE—The purpose of this study was to assess the relationship between adherence to statin therapy and LDL cholesterol goal achievement in patients with diabetes and dyslipidemia. RESEARCH DESIGN AND METHODS—The records of patients being medically treated for dyslipidemia in a managed care diabetes program from January 2001 to December 2002 were used to assess LDL cholesterol goal attainment ( RESULTS—A total of 653 patient records was analyzed. The average MPR was significantly higher for men than for women (0.75 vs. 0.66, P CONCLUSIONS— Although statins are highly effective for decreasing LDL cholesterol levels in patients with dyslipidemia, including those with diabetes, failure to reach LDL cholesterol targets remains common. Adherence to statin therapy, as reflected by MPR, is closely related to LDL cholesterol goal attainment in patients with diabetes and dyslipidemia. The probability of goal achievement appears to increase substantially when the MPR is >0.80. Pharmacy records can be used to identify patients who are poorly compliant with statin therapy and at high risk for failure to attain LDL cholesterol goals. Because outcomes are directly related to patients’ medication-taking behavior, when clinical goals (such as serum cholesterol levels) are not being reached, adherence should be the first item assessed by the clinician.

https://care.diabetesjournals.org/content/diacare/28/3/595.full.pdf

Adherence to statin therapy and LDL cholesterol goal attainment by patients with diabetes and dyslipidemia.

https://www.onlinecjc.ca/article/S0828-282X(10)70454-2/pdf

Prevalence of dyslipidemia in statin-treated patients in Canada: Results of the DYSlipidemia International Study (DYSIS)

Genetic and immunologic susceptibility to statin-related myopathy.

Objective: The beneficial effect of lipid-lowering drugs (LLDs) is well documented. Despite increasing sales of LLDs, little is known about what characterizes LLD users. Our objective was to describe LLD users in a general population according to socio-demographic factors, cardiovascular risk factors and coronary heart disease (CHD), and to study the achievement of cholesterol treatment goals according to national guidelines. Methods: The Tromso study is a population-based study of chronic diseases, risk factors and drug use in the municipality Tromso, in north Norway. The fifth survey was conducted in 2001 and included 7,973 men and women (attendance rate 78.1%). Self-reported use of LLDs and/or proprietary LLDs was included as LLD use in the analysis. Results: LLD use was reported in 9.6% of all women and 14.0% of all men, of whom 36.5% achieved the nationally recommended lipid goal. Among individuals with CHD, 49.9% of all women and 55.4% of all men were LLD users. The individuals with a risk condition (hypertension and/or diabetes) and total cholesterol level above the target of 5.0 mmol/l and the healthy individuals with total cholesterol level ≥8.0 mmol/l constituted 47.2% of the study population without CHD. In this group, which was eligible for primary prevention, 8.0% of the women and 7.4% of the men reported LLD use. Conclusions: Only half of all subjects with CHD were taking a LLD. The large discrepancy between national recommendations and actual LLD use in primary prevention should be addressed in future revisions of the guidelines.

Whom are we treating with lipid-lowering drugs? Are we following the guidelines? Evidence from a population-based study: the Tromso study 2001.

• Objectives: To evaluate hyperlipidemia treatment and to assess the effectiveness of statins in patients with established coronary heart disease (CHD). • Design: Retrospective analysis of claims data from a large national managed care organization in the United States. • Setting and participants: Health insurance plan members at least 18 years of age who had CHD or atherosclerosis, had pharmacy benefits, and were continuously enrolled in the health plan from 1 January 1998 through 31 December 1999. • Measures: CHD comorbidities, utilization of statin therapy, compliance with statin therapy, and achievement of the National Cholesterol Education Program (NCEP) goal for low-density lipoprotein cholesterol (LDL-C ≤ 100 mg/dL) were assessed. • Results: Of 29,534 eligible patients, 43% (12,781) were receiving statin therapy; of these, 46% (5943) continued therapy through study end. Only 59% (17,402) had 1 or more cholesterol-monitoring tests during the 2-year study period. A subgroup of 641 patients with at least 1 coronary event in 1998 who had LDL-C data available for 1999 was analyzed; the NCEP goal for LDL-C was met in only 48% (308) of this group. This goal was more likely to be reached among statin users (odds ratio [OR], 1.78 [95% confidence interval {CI}, 1.23‐2.56]), particularly those with a higher rate of compliance with therapy (OR, 2.09 [95% CI, 1.32‐3.31]). • Conclusions: Hyperlipidemia management in CHD patients needs further improvement, especially in early identification and use of statin therapy in patients with difficult-to-control cholesterol levels. Compliance with statin therapy was the leading predictor of ability to reach the target cholesterol goal in the subgroup (n = 641) analysis.

Cholesterol Management in a Population of Managed Care Enrollees

Lipid Treatment Goals Achieved in Patients Treated With Statin Drugs in Norwegian General Practice

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Lipid Treatment Goals Achieved in Patients Treated With Statin Drugs in Norwegian General Practice