Adherence to Statin Therapy and LDL Cholesterol Goal Attainment by Patients With Diabetes and Dyslipidemia
Open accessAbstract
OBJECTIVE—The purpose of this study was to assess the relationship between adherence to statin therapy and LDL cholesterol goal achievement in patients with diabetes and dyslipidemia. RESEARCH DESIGN AND METHODS—The records of patients being medically treated for dyslipidemia in a managed care diabetes program from January 2001 to December 2002 were used to assess LDL cholesterol goal attainment (<100 mg/dl) and to compute a 9-month medication possession ratio (percentage of days when medication was available [MPR], beginning with the first prescription in the database). RESULTS—A total of 653 patient records was analyzed. The average MPR was significantly higher for men than for women (0.75 vs. 0.66, P < 0.05). Overall, 44% (n = 290) of the patients achieved an LDL cholesterol level <100 mg/dl (52% of men and 37% of women, P < 0.05). A significant correlation emerged between MPR and plasma LDL cholesterol (P < 0.001), and MPR was significantly higher in patients who achieved the LDL cholesterol target than in those who did not (0.82 vs. 0.61, P < 0.05). CONCLUSIONS— Although statins are highly effective for decreasing LDL cholesterol levels in patients with dyslipidemia, including those with diabetes, failure to reach LDL cholesterol targets remains common. Adherence to statin therapy, as reflected by MPR, is closely related to LDL cholesterol goal attainment in patients with diabetes and dyslipidemia. The probability of goal achievement appears to increase substantially when the MPR is >0.80. Pharmacy records can be used to identify patients who are poorly compliant with statin therapy and at high risk for failure to attain LDL cholesterol goals. Because outcomes are directly related to patients’ medication-taking behavior, when clinical goals (such as serum cholesterol levels) are not being reached, adherence should be the first item assessed by the clinician.
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Despite treatment with statins, patients with elevated low-density lipoprotein cholesterol and triglycerides remain at increased risk for adverse cardiovascular events.
“Despite treatment with statins, patients with elevated low-density lipoprotein cholesterol (LDL-C) and triglycerides remain at increased risk for adverse cardiovascular events.”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [11]
The introduction (section “M”; page not available) links diabetes with elevated cholesterol and increased coronary risk. The “MPR and LDL cholesterol goal attainment” section says failure to reach LDL goals amplifies morbidity and mortality in patients with dyslipidemia. The paper does not address elevated triglycerides as a cardiovascular risk among statin-treated patients, and its discussion is principally about patients with diabetes and dyslipidemia. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe majority of patients with dyslipidaemia do not attain adequate LDL-C levels by existing lifestyle modifications and pharmacological treatment strategies.
“Despite the widespread availability of low-cost statins, the majority of patients with dyslipidaemia do not attain adequate LDL-C levels by existing lifestyle modifications and pharmacological treatment strategies [7–11].”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [11]
The RESULTS section reports that only 44% of the study’s patients with diabetes and dyslipidemia reached their LDL-C goal. The MPR and LDL cholesterol goal attainment section also reports a survey in which 38% reached their targets. These passages support the majority-not-at-goal point, but they do not establish that lifestyle modifications were among the strategies used or assess the claim for all patients with dyslipidemia. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Parris, E. S., Lawrence, D. B., Mohn, L. A., & Long, L. B.
- Affiliations
- Pfizer (United States) (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-03-01
- Volume
- 28
- Issue
- 3
- Pages
- 595-599
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2166894879
- Semantic Scholar
- adb486a696da721e23255f14e19ba2c7e23c508f
- Cited by
- 155
- References
- 30
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 8 · 2019: 2 · 2018: 5 · 2017: 6 · 2016: 10 · 2015: 14 · 2014: 8 · 2013: 11 · 2012: 9
- FWCI
- 8.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- statin therapy, medication adherence, LDL cholesterol goal attainment, dyslipidemia, diabetes mellitus, medication possession ratio, sex differences, pharmacy records, managed care
- MeSH terms
- Anticholesteremic Agents, Female, Health Maintenance Organizations, Humans, Hyperlipidemias, Cholesterol, LDL, Male, Medical Records, Retrospective Studies, Sex Differentiation, Databases, Factual, Diabetes Complications
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