Multivariate Analysis of Factors Associated With Persistent Colesevelam Treatment Among Patients With Hypercholesterolemia

BACKGROUND: Persistent treatment with lipid-lowering therapies is important for achieving optimal clinical outcomes. To date, no study has evaluated the real-world use of colesevelam and the factors associated with persistent colesevelam treatment. OBJECTIVE: The primary objective of this study was to examine patient demographic and characteristics associated with persistent colesevelam treatment in real-world clinical practice. METHODS: In this retrospective cohort study, adult patients with hypercholesterolemia, an initial order for colesevelam between January 2004 and December 2011, a low-density lipoprotein cholesterol (LDL-C) value ≤ 3 months from the initial order date (baseline), and ≥ 12 months of follow-up were identified through electronic health records. Persistent treatment was defined as no medication order gap >30 days during a 12-month period. Multivariate logistic regression was performed to assess factors associated with persistent treatment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A P value <.05 was considered statistically significant. RESULTS: A total of 971 patients met eligibility criteria. Forty-nine percent of patients had ≥ 12 months of persistent treatment. Multivariate analysis showed that female sex (OR = 0.69; 95% CI = 0.53, 0.90; P = .004) was associated with lesser odds of persistence, whereas baseline LDL-C at goal (1.39; 1.06, 1.82; P = .015) and concomitant use of the intestinal cholesterol absorption inhibitor ezetimibe (1.64; 1.18, 2.28; P = .003) were associated with greater odds of persistence. CONCLUSIONS: This study identified several patient demographic and characteristics associated with persistent colesevelam treatment that may help develop strategies to improve treatment persistence and optimize clinical outcomes.