Cited by 268Medication Adherence and ComplianceLipoproteins and Cardiovascular HealthSex and Gender in Healthcare

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Gender and racial disparities in adherence to statin therapy: A meta-analysis

Lewey, Jennifer, Shrank, William H., Bowry, Ashna D.K., Kilabuk, Elaine, Brennan, Troyen A., Choudhry, Niteesh K.·2013·American Heart Journal

DOI 10.1016/j.ahj.2013.02.011

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Abstract

Background Significant disparities exist in cardiovascular outcomes based on race/ethnicity and gender. Rates of evidence-based medication use and long-term medication adherence also appear to be lower in racial subgroups and women but have been subject to little attention. Our objective was to evaluate the effect of race/ethnicity and gender on adherence to statin therapy for primary or secondary prevention. Methods and results Studies were identified through a systematic search of MEDLINE, EMBASE, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews (through April 1, 2010) and manual examination of references in selected articles. Studies reporting on adherence to statins by men and women or patients of white and nonwhite race were included. Information on study design, adherence measurement, duration, geographic location, sample size, and patient demographics was extracted using a standardized protocol. From 3,022 potentially relevant publications, 53 studies were included. Compared with men, women had a 10% greater odds of nonadherence (odds ratio 1.10, 95% confidence interval [CI], 1.07-1.13). Nonwhite race patients had a 53% greater odds of nonadherence than white race patients (odds ratio 1.53, 95% CI 1.25-1.87). There was significant heterogeneity in the pooled estimate for gender (I(2) 0.95, P value for heterogeneity <.001) and race (I(2) 0.98, P value for heterogeneity <.001). The overall results remained unchanged in those subgroups that had significantly less heterogeneity. Conclusions Among patients prescribed statins, women and nonwhite patients are at increased risk for nonadherence. Further research is needed to identify interventions best suited to improve adherence in these populations.

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Authors: Lewey, J., Shrank, W. H., Bowry, A. D. K., Kilabuk, E., Brennan, T. A., & Choudhry, N. K.
Affiliations: Brigham and Women's Hospital (US)
St. Michael's Hospital (CA)
CVS Health (United States) (US)
Corresponding author: Choudhry, Niteesh K.
ORCID: Lewey, Jennifer
Choudhry, Niteesh K.
Venue: American Heart Journal
Publisher: Elsevier BV
Published: 2013-05
Volume: 165
Issue: 5
Pages: 665-678.e1
ISSN: 0002-8703 (ISSN-L)
DOI: 10.1016/j.ahj.2013.02.011
OpenAlex: W2100554124
Cited by: 267
References: 98
Citations by year: 2026: 14 · 2025: 22 · 2024: 17 · 2023: 13 · 2022: 26 · 2021: 26 · 2020: 27 · 2019: 21 · 2018: 16 · 2017: 21 · 2016: 22 · 2015: 20 · 2014: 19 · 2013: 3
FWCI: 2.82
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Heart Journal (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
Keywords: statin therapy, medication adherence, non-compliance, gender disparities, racial disparities, ethnic minorities, women, cardiovascular disease prevention, secondary prevention, health disparities
MeSH terms: Cardiovascular Diseases, Humans, Morbidity, Sex Factors, Global Health, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Racial Groups, Medication Adherence

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Gender and racial disparities in adherence to statin therapy: A meta-analysis

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