Predictors of Nonadherence to Statins: A Systematic Review and Meta-Analysis
Open accessAbstract
Background: Nonadherence to statins limits the benefits of this common drug class. Individual studies assessing predictors of nonadherence haue produced inconsistent results. Objective: To identify reliable predictors of nonadherence to statins through systematic review and meta-analysis. Methods: Multiple databases, including MEDLINE, EMBASE, and PsycINFO, were searched (from inception through February 2009) to identify studies that evaluated predictors of nonadherence to statins. Studies were selected using a priori defined criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics and outcomes. Relative risks were then pooled, using an inverse-variance weighted random-effects model. Results: Twenty-two cohort studies met inclusion criteria. Age had a U-shaped association with adherence; the oldest (≥70 years) and youngest (<50 years) subjects had lower adherence than the middle-aged (50-69 years) subjects. Women and patients with lower incomes were more likely to be nonadherent than were men (odds of nonadherence 1.07; 95% CI 1.04 to 1.11) and those with higher incomes (odds of nonadherence 1.18:95% CI 1.10 to 1.28), respectively. A history of cardiovascular disease predicted better adherence to statins (odds of nonadherence 0.68; 95% CI 0.66 to 0.78). Similarly, a diagnosis of hypertension or diabetes was associated with better adherence. Although there were too few studies for quantitative pooling, increased testing of lipid levels and lower out-of-pocket costs appeared to be associated with better adherence. There was substantial (l2 range 68.7-96.3%) heterogeneity between studies across factors. Conclusions: Several sociodemographic, medical, and health-care utilization characteristics are associated with statin nonadherence. These factors may be useful guides for targeting statin adherence interventions.
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Compound drugs improve patient adherence to medication compared with prescribing the drugs separately.
“It has been reported that compound drugs improve patient adherence to medication compared to prescribing the drugs separately717).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [717]
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- Authors
- Mann, D. M., Woodward, M., Muntner, P., Falzon, L., & Kronish, I.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- The University of Sydney (AU)
- University of Alabama at Birmingham (US)
- Columbia University Irving Medical Center (US)
- Venue
- Annals of Pharmacotherapy
- Publisher
- SAGE Publications
- Published
- 2010-08-11
- Volume
- 44
- Issue
- 9
- Pages
- 1410-1421
- ISSN
- 0012-6578 (ISSN-L)
- 1060-0280
- 1542-6270
- PMC
- PMC3641194
- OpenAlex
- W2097319856
- Cited by
- 329
- References
- 44
- Citations by year
- 2026: 16 · 2025: 11 · 2024: 12 · 2023: 19 · 2022: 15 · 2021: 32 · 2020: 16 · 2019: 23 · 2018: 36 · 2017: 29 · 2016: 37 · 2015: 24 · 2014: 23 · 2013: 15 · 2012: 13
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Annals of Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Heart, Lung, and Blood Institute (K23HL098359)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK081665)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- medication adherence, predictors of non-adherence, age, sex differences, income, cardiovascular disease history, hypertension, diabetes mellitus, lipid testing, out-of-pocket costs, adherence interventions
- MeSH terms
- Age Factors, Cardiovascular Diseases, Diabetes Mellitus, Humans, Hypertension, Patient Compliance, Socioeconomic Factors, Cohort Studies, Comorbidity, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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