Evidence map›Paper›PMID 12132976›Full record

ArticleJAMA

Adherence with statin therapy in elderly patients with and without acute coronary syndromes.

Cynthia A Jackevicius, Muhammad Mamdani, Jack V Tu

3 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in JAMA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT01770210. Cited by 341 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
341citing papers in PubMed, 12 pooled it
41.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01770210 completed

A Multicenter, Open-label, 30-week Observational Clinical Study to Examine the Progress of Patients After Leaving the Cardiology Clinic or Unit Due to Acute Cardiovascular Event.

Ran2013Enrolled670Registered outcomes6Posted comparisons0ConditionsCardiovascular DisordersArmsPatients on atorvastatin treatment
PMID 20425272PMID 12132975PMID 12181210PMID 12505111PMID 15883224PMID 19367148PMID 11966668PMID 8604188PMID 9416884PMID 9851392PMID 11914253other papers from this trial
Open the trial in the graph
NCT00393419 nacompletednot on this map

Federal Study of Adherence to Medications in the Elderly (FAME)

TypeinterventionalSponsorWalter Reed Army Medical CenterRan2004 to 2006Enrolled200ConditionsMedication Adherence, Hypertension, HyperlipidemiaArmsComprehensive pharmacy care program
NCT01068834 completednot on this map

Additional KIF6 Risk Offers Better Adherence to Statins

TypeobservationalSponsorMedco Health Solutions, Inc.Ran2010 to 2011Enrolled1,282ConditionsCardiovascular Diseases, DyslipidemiaArmsKIF6 genetic test
3 · Its place in the literature

Who cites it

341 citing papers in PubMed, 12 syntheses or guidelines pooled it, 1,081 citations in OpenAlex.

  1. Pooled it
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  3. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
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  8. Interventions to improve adherence to lipid-lowering medication.The Cochrane database of systematic reviews · 2016
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  12. Statins for acute coronary syndrome.The Cochrane database of systematic reviews · 2014 · on this map
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  14. Description of patient questions received by clinical pharmacists in the Nudge Study.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2023
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281 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Cynthia A JackeviciusDepartment of Health Policy, Management, and Evaluation, Pharmacy Department and Women's Health Program, University Health Network-Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4. Cynthia.Jackevicius@uhn.on.ca
Muhammad Mamdani
Jack V Tu
Toronto General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextLandmark clinical trials have demonstrated the survival benefits of statins, with benefits usually starting after 1 to 2 years of treatment. Research prior to these trials of older lipid-lowering agents demonstrated low levels of 1-year adherence.

objectiveTo compare 2-year adherence following statin initiation in 3 cohorts of patients: those with recent acute coronary syndrome (ACS), those with chronic coronary artery disease (CAD), and those without coronary disease (primary prevention). DESIGN AND

settingCohort study using linked population-based administrative data from Ontario. PATIENTS: All patients aged 66 years or older who received at least 1 statin prescription between January 1994 and December 1998 and who did not have a statin prescription in the prior year were followed up for 2 years from their first statin prescription. There were 22,379 patients in the ACS, 36,106 in the chronic CAD, and 85,020 in the primary prevention cohorts.

main outcome measuresAdherence to statins, defined as a statin being dispensed at least every 120 days after the index prescription for 2 years.

resultsTwo-year adherence rates in the cohorts were only 40.1% for ACS, 36.1% for chronic CAD, and 25.4% for primary prevention. Relative to the ACS cohort, nonadherence was more likely among patients receiving statins in the chronic CAD (relative risk [RR], 1.14; 95% CI, 1.11-1.16) and primary prevention cohorts (RR, 1.92; 95% CI, 1.87-1.96).

conclusionsElderly patients with and without recent ACS have low rates of adherence to statins. This suggests that many patients initiating statin therapy may receive no or limited benefit from statins because of premature discontinuation.

Indexed as

Patient ComplianceAcute DiseaseAgedChronic DiseaseCohort StudiesCoronary DiseaseFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypolipidemic AgentsMaleProportional Hazards ModelsTimeHydroxymethylglutaryl-CoA Reductase InhibitorsHypolipidemic Agents

Identifiers

PMID12132976
OpenAlexW2085828681

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.