Evidence map›Paper›PMID 15209602›Full record

ArticleJournal of general internal medicine2004

Suboptimal statin adherence and discontinuation in primary and secondary prevention populations.

Jeffrey J Ellis, Steven R Erickson, James G Stevenson, Steven J Bernstein, Renee A Stiles, A Mark Fendrick

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 4 pooled it
15.0field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 4 syntheses or guidelines pooled it, 320 citations in OpenAlex.

  1. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
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  7. Medication Discontinuation in the IMPROVE-IT Trial.Circulation. Cardiovascular quality and outcomes · 2019
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57 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jeffrey J EllisDepartment of Pharmacy Services, University of Michigan Hospitals and Health Centers, Ann Arbor, Michigan, USA. ellisj2@ccf.org
Steven R Erickson
James G Stevenson
Steven J Bernstein
Renee A Stiles
A Mark Fendrick
University of Michigan–Ann Arbor · USVanderbilt University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare statin nonadherence and discontinuation rates of primary and secondary prevention populations and to identify factors that may affect those suboptimal medication-taking behaviors.

designRetrospective cohort utilizing pharmacy claims and administrative databases.

settingA midwestern U.S. university-affiliated hospital and managed care organization (MCO). PATIENTS: Non-Medicaid MCO enrollees, 18 years old and older, who filled 2 or more statin prescriptions from January 1998 to November 2001; 2258 secondary and 2544 primary prevention patients were identified. MEASUREMENTS: Nonadherence was assessed by the percent of days without medication (gap) over days of active statin use, a measurement known as cumulative multiple refill-interval gap (CMG). Discontinuation was identified by cessation of statin refills prior to the end of available pharmacy claims data.

resultsOn average, the primary and secondary groups went without medication 20.4% and 21.5% of the time, respectively (P=.149). Primary prevention patients were more likely to discontinue statin therapy relative to the secondary prevention cohort (relative risk [RR], 1.24; 95% confidence interval [CI], 1.08 to 1.43). Several factors influenced nonadherence and discontinuation. Fifty percent of patients whose average monthly statin copayment was < US dollars 10 discontinued by the end of follow-up (3.9 years), whereas 50% of those who paid >US dollars 10 but <or=US dollars 20 and >US dollars 20 discontinued by 2.2 and 1.0 years, respectively (RR, 1.39 and 4.30 relative to <US dollars 10 copay, respectively).

conclusionsStatin nonadherence and discontinuation was suboptimal and similar across prevention categories. Incremental efforts, including those that decrease out-of-pocket pharmaceutical expenditures, should focus on improving adherence in high-risk populations most likely to benefit from statin use.

Indexed as

Primary PreventionTreatment RefusalCohort StudiesCoronary DiseaseCost-Benefit AnalysisDatabases as TopicDelivery of Health CareFemaleFinancing, PersonalHospitals, UniversityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleManaged Care ProgramsMiddle AgedOdds RatioHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID15209602
PMCPMC1492382
OpenAlexW1533985811

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.