Factors that contribute to poor adherence to statin therapy in coronary heart disease patients from Chongqing and measures to improve their therapeutic outcomes.
To assess the efficacy and short-term outcomes of adherence to statin therapy among coronary heart disease (CHD) patients following their hospital discharge, we enrolled 615 CHD patients who were prescribed statins from The First Affiliated Hospital of Chongqing Medical University in China between February 1st and October 31st of 2013. Statin adherence was evaluated by identifying the proportion of patients who remained adherent or became non-adherent to statin therapy over 4-8 months post-discharge from the hospital. The composite outcomes included all-cause mortality and re-hospitalization with cardiovascular disease. We found that 15.9% patients were non-adherent to their statin therapies and that coronary artery stenosis<75% (OR = 3.433, 95% CI: 2.191-5.380, p < 0.001) and adverse effects (OR = 2.542, 95% CI: 1.327-4.869, p = 0.005) both clearly contributed to poor adherence. The primary self-reported reasons for non-adherence included a lack of knowledge about the benefits of statin therapy (36.7%), the treatment being halted at the advice of their doctor (19.4%), and the difficulty in obtaining statins (12.2%). Non-adherence to statin therapy was significantly associated with an increased risk of cardiovascular events (OR = 1.741, 95% CI: 1.035-2.929, p = 0.037). In conclusion, CHD patients with moderate stenosis or adverse effects tended to have poor statin adherence, and this was significantly associated with increased cardiovascular events. We should strengthen education of the importance of statin therapy for both patients and doctors and facilitate the ability of patients to obtain their statin medication. Clinical Study Register Code: ChiCTR-EPC-16007839.
['Yu|Guiquan|G|', 'Zhang|Yingjiao|Y|', 'Wang|Ying|Y|', 'Chang|Guanglei|G|', 'Tao|Hongmei|H|', 'Zhang|Dongying|D|']
Adherence Statin Coronary heart disease Adverse effects Cardiovascular events BP, blood pressure CHD, coronary heart disease CI, confidence interval HR, hazard ratio LDL-C, low-density lipoprotein-cholesterol MACE, major adverse cardiac events OR, odds ratio PDC, proportion of days covered SD, standard deviation ULN, upper limits of normal