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Cited by 28Medication Adherence and CompliancePharmacy and Medical PracticesLipoproteins and Cardiovascular Health

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial

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Oñatibia‐Astibia, Ainhoa, Malet‐Larrea, Amaia, Larrañaga, Belen, Gastelurrutia, Miguel Ángel, Calvo, Begoña, Ramírez, Dulce, Cantero, Ignacio, Garay, Ángel +1 more·2019·Health Services Research
DOI 10.1111/1475-6773.13152PMC PMC6505412
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Abstract

Objective: To evaluate the impact of health professionals’ intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. Study Setting: Forty‐six community pharmacies and 50 primary care centers of Spain. Study Design: Randomized controlled trial design (n = 746). Patients were assigned into adherent (ADH) or nonadherent group depending on their initial adherence to statins. Nonadherent patients were randomly assigned to intervention (INT) or nonintervention (NOINT) group. Patients enrolled in the INT group received an intervention depending on the cause of nonadherence. Patients in the ADH and NOINT groups received usual care. Intention‐to‐treat (ITT) analysis was performed with multiple imputation to replace the missing data. Data Collection: Adherence, total cholesterol levels, and lifestyle behaviors. Findings: The odds of becoming adherent during the 6 months was higher in the INT group compared to the NOINT group (OR = 1,49; 95% CI: 1.30‐1.76; P < 0.001), especially in the community pharmacy group (OR = 2.34; 95% CI: 1.81‐3.03; P < 0.001). Adherent patients showed lower values of total cholesterol compared with nonadherent patients at baseline (ADH: 200.3 mg/dL vs NOADH: 216.7 mg/dL; P < 0.001) and at the endpoint (ADH: 197.3 mg/dL vs NOADH: 212.2 mg/dL; P < 0.001). More patients enrolled in the INT group practices exercise at the end of the study (INT: +26.6 percent; P = 0.002), and a greater number of patients followed a diet to treat hypercholesterolemia (+30.2 percent; P < 0.001). Conclusions: The intervention performed by health professionals, especially by community pharmacists, improved adherence to statins by hypercholesterolemic patients, and this improvement in adherence was accompanied by a reduction in total cholesterol levels and a healthier lifestyle.

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  • Tailored interventions targeting LLMs are more likely to improve adherence.

    “These findings suggests that tailored interventions targeting LLMs are more likely to improve adherence, as non-adherence to different classes of medication likely requires distinct, personalised approaches.”

    From Interventions to improve adherence to lipid-lowering drugs: a systematic review and meta-analysis (2025) · cites this paper as [42]

    The Discussion reports that interventions tailored to the cause of nonadherence improved adherence to statins after six months, supporting the claim for that lipid-lowering medication. The paper does not establish that nonadherence across different medication classes requires distinct approaches or compare tailored interventions across those classes. The indexed passages provide section labels but no page numbers. (LLM, conf=0.84)

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Authors
Oñatibia‐Astibia, A., Malet‐Larrea, A., Larrañaga, B., Gastelurrutia, M. Á., Calvo, B., Ramírez, D., Cantero, I., Garay, Á., & Goyenechea, E.
Affiliations
  • Official Pharmacist Association of Gipuzkoa Donostia/San Sebastián Spain
  • Universidad de Granada (ES)
  • University of the Basque Country (ES)
  • Treatment Adherence Observatory Madrid Spain
Corresponding author
Oñatibia‐Astibia, Ainhoa
ORCID
Venue
Health Services Research
Publisher
Wiley
Published
2019-04-07
Volume
54
Issue
3
Pages
658-668
ISSN
  • 0017-9124 (ISSN-L)
  • 1475-6773
DOI
10.1111/1475-6773.13152
PMC
PMC6505412
OpenAlex
W2937898739
Cited by
28
References
4
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 2 · 2020: 8
FWCI
4.37
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Health Services Research (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Teva Pharmaceutical Industries
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
statin adherence, medication adherence, hypercholesterolemia, community pharmacists, general practitioners, personalized interventions, total cholesterol, lifestyle habits, physical activity, dietary adherence, primary care, community pharmacy
MeSH terms
Assessment of Medication Adherence, Aged, Cholesterol, Female, Humans, Hypercholesterolemia, Health Knowledge, Attitudes, Practice, Life Style, Male, Middle Aged, Pharmacists, Socioeconomic Factors, Spain, Drug Monitoring, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Medication Adherence, General Practitioners

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