Key result
Adherence to statin dose-count and dose-time were weakly and marginally associated with percent reduction in serum LDL-cholesterol (R2=0.130, P=0.001 and R2=0.048, P=0.047, respectively).
Why the study?
Does adherence to statin therapy correlate with serum LDL-cholesterol reduction in Chinese patients at high risk of CHD?
Cohort (n=83)
No
Does adherence to statin therapy correlate with serum LDL-cholesterol reduction in Chinese patients at high risk of CHD?
p-value: p=0.001
In Chinese patients at high risk of CHD, adherence to statin therapy is high but declines slightly over time, and is weakly correlated with LDL-cholesterol reduction.
Adherence explains minimal LDL-C variability; leaves open other determinants and does not support practice change in high-risk Chinese patients.
AIMS: To examine the pattern of adherence to statin therapy and to determine the association of adherence to statin therapy and the control of serum low-density lipoprotein (LDL)-cholesterol in a cohort of Hong Kong Chinese patients at high risk of coronary heart disease (CHD). METHODS: This was a prospective observational cohort study conducted at the outpatient clinics of a public teaching hospital in Hong Kong. Patients at high risk of CHD who had been initiated on statin monotherapy for < 12 months were recruited. The statin prescription was dispensed in a bottle with the Medication Event Monitoring System (MEMS). Adherence was assessed in two dimensions: dose-count was defined as the percentage of doses taken, and dose-time was defined as the percentage of doses taken within the suggested time interval. Lipid profiles were obtained at baseline and during two follow-up visits at month 3 and month 6. RESULTS: Eighty-three patients completed the study. The median adherence to dose-count and to dose-time were 95% (25-75th percentile = 87-99%) and 78% (25-75th percentile = 17-92%), respectively. Both dose-count and dose-time adherence declined slightly over the first 6 months of therapy. Living with family [relative risk (RR) = 0.79, 95% confidence interval (CI) 0.63, 0.91] and duration of therapy (RR = 0.99, 95% CI 0.98, 1.00) were negative predictors while number of family members (among those living with family) (RR = 1.05, 95% CI 1.00, 1.08) was a positive predictor for adherence to dose-count. Monthly household income (RR = 1.01, 95% CI 1.00, 1.02) and angina (RR = 1.29, 95% CI 1.05, 1.58) were positive predictors while living with family (RR = 0.74, 95% CI 0.55, 0.90) was a negative predictor for dose-time adherence. Percent reduction in serum LDL-cholesterol was correlated to dose-count (P < 0.001) and dose-time (P = 0.047) adherence. Statistically significant correlations were observed between adherence to dose-count and LDL reduction (R(2) = 0.130; P = 0.001), and between dose-time adherence and LDL reduction (R(2) = 0.048; P = 0.047). CONCLUSION: High adherence to statin therapy was found in a cohort of Chinese patients at high risk of CHD and the adherence declined slightly over time. A weak association between adherence to statin dose-count and LDL reduction and a marginal association between dose-time adherence and LDL reduction were observed.
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Cheng et al. (2004) conducted a cohort in High risk of coronary heart disease (n=83). Adherence to statin therapy was evaluated on Percent reduction in serum LDL-cholesterol (p=0.001). Adherence to statin dose-count and dose-time were weakly and marginally associated with percent reduction in serum LDL-cholesterol (R2=0.130, P=0.001 and R2=0.048, P=0.047, respectively).
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