July 24/31, 2002

Elderly Patients' Adherence to Statin Therapy

Author Affiliations

Author Affiliation: Wake Forest University Health Sciences, Winston-Salem, NC.

JAMA. 2002;288(4):495-497. doi:10.1001/jama.288.4.495

In this issue of THE JOURNAL, 2 articles present important new data that indicate persistence of use of statin therapy declines remarkably over time in 2 different elderly cohorts.1,2 Benner and colleagues1 used data from both New Jersey Medicaid and Pharmaceutical Assistance to the Aged and Disabled programs (1990-1999) to determine adherence with prescribed medication over a given time interval. They also evaluated persistence, defined as the duration of time over which a patient continued to fill the statin prescriptions. Filled prescription intervals were used to calculate the proportion of days covered by a statin in each quarter of a year after initiation of therapy. In the study by Jackevicius and colleagues,2 several large databases from Ontario, Canada (1994-1998), were merged, including one of drug benefits, another of hospital discharge summaries, and another of health insurance benefits. In this latter study, adherence was calculated simply as having a statin prescription refilled within 120 days of the index prescription. Despite different methods of defining adherence, the findings of the 2 studies are remarkably consistent and alarming given the efficiency of statins in reducing cardiovascular morbidity. In both studies, adherence to statin therapy declined more than 25% in the first 6 months after the original prescription, with further declines in adherence the longer the cohort was followed.

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