Poster Session III: Epidemiology and public health

Abstract

P346 Adherence with statins in a real-life setting is better when cardiovascular risk factors increase T Couffinhal, P Latry, M Molimar, B Begaud, M Lafitte, K Martin-Latry University Hospital of Bordeaux Hospital Haut Leveque, Departement of Cardiology, Pessac, France, Direction Regionale du Service Medical de l’Assurance Maladie d’Aquitaine, CNAMTS, Bordeaux, France, Inserm U 657, Universite Victor Segalen Bordeaux 2, Bordeaux, France Topic: Pharmacoepidemiology Background: Several studies have shown poor adherence to statin treatments and several associated factors have been highlighted: younger age, insufficient revenue, absence of cardiovascular morbidity, women, number of coprescribed drugs. While the factors for poor adherence have been highlighted, the impact of their combination on adherence is not clear. Purpose: To estimate adherence for statins and whether it differs according to the number of cardiovascular risk factors. Methods: A cohort study was conducted using data from the French social security insurance database. Patients were included if they submitted a reimbursement form for a prescription for statins between September 1 and December 31, 2004, and did not receive any statin treatment for 6 months previous to this. Patients were followed up 15 months. Statin use was considered a proxy for hypercholesterolemia. The cohort was split into three groups according to their number of additional cardiovascular risk factors that included age and gender, diabetes mellitus and cardiovascular disease (using co-medications as a proxy). Adherence was assessed for each group by using four parameters: (i) proportion of days covered by statins, (ii) regularity of the treatment over time, (iii) persistence, and (iv) the patient s understanding of the treatment. Results: 16,397 newly treated patients were identified. Of these statin users, 21.7 % did not have additional cardiovascular risk factors. Thirty-one percent had two cardiovascular risk factor and 47% had at least three risk factors. All the parameters showed a sub-optimal adherence whatever the group: days covered ranged from 56 % to 72 %, regularity ranged from 23 % to 33 % and persistence ranged from 44 % to 59 %, but adherence was better for those with a higher number of cardiovascular risk factors. Conclusions: The results confirm that long-term drug treatments are a difficult challenge, particularly in patients at lower risk.