| Abstract [eng] |
Background. Cardiovascular diseases (CVD) are one of the main causes of death in European Union taking over a million of lives every year. Many different factors increase the chances of build-up of fatty deposits on the walls of the arteries around the heart, which greatly increases the risk of CVD events. Low-density lipoprotein (LDL) lowering medications such as statins play a huge role in the prevention and treatment of cardiovascular diseases. Statins have been shown to have a big impact in reducing the risk of major vascular events and mortality both in primary and secondary prevention. Despite the statin-based benefits, statins are still not sufficiently prescribed for patients and they not properly utilized by patients. In various scientific studies, patients adherence and persistence rate to the treatment is insufficient to achieve the desired result in CVD prevention. Aim. To evaluate the persistence to statin treatment in Lithuania during 2018-2019 and to investigate factors possibly associated with non-persistence. Research objectives. 1. To assess whether patients are more likely to be persistent to statins treatment in secondary prevention than the patients treated for primary prevention. 2. To investigate whether there any difference in persistence depending on patient sex, age or previous use of other medicines. 3. To assess whether there is any difference in persistence between different statins and dosages used. 4. To measure what is the persistence to statins during the study period. 5. To investigate whether the title of the specialist qualification influences in patient persistence. Methods. In this cohort study, data on dispensed and reimbursed prescription medicines were obtained from the information system "Sveidra" of the Lithuanian National Health Insurance Fund (NHIF). All adult patients who had their first statin dispensed in 2018-2019 were included. Persistence was assessed using the anniversary method, i.e. determined the number of patients who had no statin dispensed 365 days after the first dispensing, taking into account a permissible gap of 90 days of supply of the last dispensing. Multivariate logistic regression was used to explore factors associated with persistence. Results and conclusions. 104’726 patients were initiated on statins treatment, they were dispensed with a statin for the first time in 2018-2019. Overall, patients were most commonly initiated with atorvastatin 60%, rosuvastatin 39%, and around 1% with simvastatin and fluvastatin together. The mean age was 62 years. In total only 41% of all initiated patients with a statin treatment were persistent after one year. Patients who had previous use of medications were 73% more likely to be persistent to statins treatment, than those who have not. Likewise, patients taking higher doses of atorvastatin were 55-62% more likely to stay persistent to the treatment than patients with lighter doses of atorvastatin. Younger patients with no previous use of other medication and patients with lower doses of statins had higher odds to become non-persistent. Patients’ prescriber qualification and gender showed no association with persistence. |
