Factors Associated with Reinitiation of Statin Treatment in Older Patients with Peripheral Arterial Disease.
Aged
Cohort Studies
Drug Administration Schedule
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ administration & dosage
Male
Medication Adherence
/ statistics & numerical data
Middle Aged
Myocardial Infarction
/ drug therapy
Peripheral Arterial Disease
/ drug therapy
Proportional Hazards Models
Secondary Prevention
/ statistics & numerical data
Journal
Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
10
6
2020
medline:
27
11
2020
entrez:
10
6
2020
Statut:
ppublish
Résumé
Long-term persistence represents a basic precondition of successful statin treatment in patients with peripheral arterial disease (PAD). The aims of our study were evaluation of reinitiation in older PAD patients who were non-persistent with statin treatment, and identification of patient-related characteristics associated with the patient's probability of reinitiation. Our study cohort included 2977 older patients (≥ 65 years) who were non-persistent with statin treatment in whom PAD was newly diagnosed in 2012. Reinitiation was defined as the first statin prescription recorded after discontinuation. To analyze factors associated with the patient´s probability of reinitiation, Cox regression with time-dependent covariates was applied. After post-discontinuation follow-up of a mean of 27 months, reinitiation of statin treatment was recorded for 1244 (41.8%) patients. Increasing age, Parkinson's disease, being a new statin user (patient in whom statin treatment was initiated in association with PAD diagnosis), general practitioner as the index prescriber who prescribed a statin for the first time after diagnosis of PAD, coadministration of loop diuretics, and longer persistence before discontinuation decreased the patient's likelihood of reinitiation, whereas myocardial infarction during non-persistence, high-intensity statin treatment, and increasing number of medications increased the patient's probability of reinitiation. In patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed.
Sections du résumé
BACKGROUND
Long-term persistence represents a basic precondition of successful statin treatment in patients with peripheral arterial disease (PAD).
OBJECTIVES
The aims of our study were evaluation of reinitiation in older PAD patients who were non-persistent with statin treatment, and identification of patient-related characteristics associated with the patient's probability of reinitiation.
METHODS
Our study cohort included 2977 older patients (≥ 65 years) who were non-persistent with statin treatment in whom PAD was newly diagnosed in 2012. Reinitiation was defined as the first statin prescription recorded after discontinuation. To analyze factors associated with the patient´s probability of reinitiation, Cox regression with time-dependent covariates was applied.
RESULTS
After post-discontinuation follow-up of a mean of 27 months, reinitiation of statin treatment was recorded for 1244 (41.8%) patients. Increasing age, Parkinson's disease, being a new statin user (patient in whom statin treatment was initiated in association with PAD diagnosis), general practitioner as the index prescriber who prescribed a statin for the first time after diagnosis of PAD, coadministration of loop diuretics, and longer persistence before discontinuation decreased the patient's likelihood of reinitiation, whereas myocardial infarction during non-persistence, high-intensity statin treatment, and increasing number of medications increased the patient's probability of reinitiation.
CONCLUSIONS
In patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed.
Identifiants
pubmed: 32514873
doi: 10.1007/s40266-020-00772-z
pii: 10.1007/s40266-020-00772-z
doi:
Substances chimiques
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
595-604Subventions
Organisme : Vedecká Grantová Agentúra MŠVVaŠ SR a SAV
ID : VEGA 1/0112/17
Pays : International
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