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Seniors
who take statins to control their heart problems usually don't
stick with it over time, according to a new study reported
in the July 23rd issue of the Journal of the American Medical
Association.
In studies
involving those in their mid-60s or older, researchers found
that adherence to statin therapy declined more than 25 percent
in the first six months after the original prescription and
the decline continued as more time passed by. The studies
determined the usage of statins by examining records regarding
the filling and refilling of prescriptions.
One study
found that the proportion of patients who adhered to statin
therapy was 60 percent, 43 percent, 26 percent, and 32 percent
after three, six, 60 and 120 months, respectively. Another
study found that two years after the initiation of statin
therapy, only 40 percent of patients who had an acute coronary
event in the last year still adhered to that therapy.
They also
found that the adherence rates were 36 percent for those of
those with clear evidence of chronic coronary artery disease
and 25 percent for those with no evidence of coronary artery
disease.
In an
accompanying editorial, Dr. William Applegate, of Wake Forest
University Health Services, said the trends of non-adherence
found in both studies are disturbing, particularly since findings
from large clinical trials have demonstrated that elderly
persons at high risk for the development of coronary artery
disease are less likely to do so when prescribed statins.
He said adherence must be improved to realize the benefits
that statins offer.
Provided
that patients gave prior informed consent for physicians to
monitor their pharmacy records over time, Applegate said this
could be a useful screening tool to begin to detect problems
with adherence to statin therapy.
For hospitalized
patients, Applegate said the timing of initiating treatment
may be important, noting that those who begin such therapy
prior to discharge are more like to stick with the regimen
two years later.
Applegate
added that providers should emphasize the importance of adhering
to statin therapy over time for all patients, but particularly
elderly ones since they are more likely to discontinue medications.
Source:
Heart
Disease Week of July 28, 2002
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