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Family practice patients’ adherence to statin medications

R. Wayne Putnam, MD CCFP FCFP
Family physician, a researcher, and an Associate Professor in the Department of Family Medicine at Dalhousie University

Alexandra M. Yip, MSc OT(C)
Research associate in the Department of Family Medicine at Dalhousie University

Dawn Frail, MSc
Manager of Drug Technology Assessment in the Nova Scotia Department of Health

Correspondence to: Dr Nandini Natarajan, Department of Family Medicine, Dalhousie University, 5909 Veterans Memorial Lane, AJLB 8101B, Halifax, NS B3H 2E2; e-mail nandini.natarajan{at}dal.ca

OBJECTIVE To measure family practice patients’ adherence to statin medications and to identify factors associated with adherence to these medications.

DESIGN Cross-sectional study using a mailed self-report survey sent to 400 patients.

SETTING Two academic family practice clinics in Halifax, NS.

PARTICIPANTS A total of 284 patients aged 40 or older who were prescribed statin medications by their family physicians, either for the first time or as a renewal during a 20-month period.

MAIN OUTCOME MEASURES Level of adherence to statin medications as measured by patients’ self-report on the Morisky scale; association between high adherence on the Morisky scale and 38 patient-reported factors.

RESULTS Response rate was 82.5%. Average age of patients was 65 years, 57% were men, 62% had been on statin medications for more than 2 years, and 97% reported that their family physicians managed their cholesterol levels. More than 63% of patients reported high adherence as measured by the Morisky scale. On multiple logistic regression, being older than 65, taking 4 to 6 other prescribed medications, and having a lifestyle that included regular exercise or a healthy diet were significant independent predictors of high adherence scores on the Morisky scale.

CONCLUSION Almost two-thirds (63%) of patients who were prescribed statins by their family physicians reported high adherence to the medications. Strategies to improve adherence would best be directed at patients who are younger or taking fewer than 4 or more than 6 other prescribed medications. Patients should be encouraged to maintain a lifestyle of regular exercise and a healthy diet, as this was associated with better adherence to statin medications.