ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2011
The association between statin use and outcomes potentially attributable to an unhealthy lifestyle in older adults.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Statins associate with lower risk of biliary tract cancers: A systematic review and meta-analysis.Cancer medicine · 2023Pooled it
- Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett's esophagus: a systematic review and meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2013Pooled it
- Adherence with protocol medication use and mortality from unrelated causes in a prevention trial.Preventive medicine · 2021Trial
- Article
- Statins and survival free of incident frailty among older US veterans.European heart journal · 2026Article
- Beyond cardiovascular protection: a conceptual and translational review of the hepato-specific mechanisms of statins in metabolic dysfunction-associated steatotic liver disease (MASLD).Frontiers in pharmacology · 2026Review
- Pharmacologic Potential of Statins in Cancer Prevention: Colo-Rectal Cancer Risk in Dyslipidemic Patients from a Korean Nationwide Cohort.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Observational
- Correlation between positive airway pressure and medication adherence: the healthy user effect.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Association Between Statin Use and Intracerebral Hemorrhage Location: A Nested Case-Control Registry Study.Neurology · 2023Article
- Immeasurable Time Bias in Self-controlled Designs: Case-crossover, Case-time-control, and Case-case-time-control Analyses.Journal of epidemiology · 2023Article
- Active Postlicensure Safety Surveillance for Recombinant Zoster Vaccine Using Electronic Health Record Data.American journal of epidemiology · 2023Article
- The effect of statins on the prevalence and mortality of influenza virus infection: a systematic review and meta-analysis.Archives of medical science : AMS · 2022Review
- Assessing forgetfulness and polypharmacy and their impact on health-related quality of life among patients with hypertension and dyslipidemia in Greece during the COVID-19 pandemic.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Article
- Consistent use of lipid lowering therapy in HIV infection is associated with low mortality.BMC infectious diseases · 2021Article
- The impact of statin use prior to intensive care unit admission on critically ill patients with sepsis.Pharmacotherapy · 2021Article
- Area-Level Predictors of Medication Nonadherence Among US Medicaid Beneficiaries With Lupus: A Multilevel Study.Arthritis care & research · 2019Article
- Influenza Vaccine Effectiveness and Statin Use Among Adults in the United States, 2011-2017.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Observational
- Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo explore the "healthy user" and "healthy adherer" effects-hypothetical sources of bias thought to arise when patients who initiate and adhere to preventive therapies are more likely to engage in healthy behaviors than are other subjects.
methodsThe authors examined the association between statin initiation and adherence, and the subsequent use of preventive health services and incidence of clinical outcomes unlikely to be associated with the need for, or use of, a statin among older enrollees in two state-sponsored drug benefit programs.
resultsAfter adjustment for demographic and clinical covariates, patients who initiated statin use were more likely to receive recommended preventive services than noninitiators matched on age, sex, and state (hazard ratio [HR]: 1.10, 1.06-1.14 for males, HR: 1.09, 1.07-1.11 for females) and appeared to have a lower risk of a range of adverse outcomes (HR: 0.87, 0.85-0.89) thought to be unrelated to statin use. Adherence to a statin regimen was also associated with increased rates of preventive service use and a decreased rate of adverse clinical outcomes (HR: 0.93, 0.88-0.99).
conclusionsThese results suggest that patients initiating and adhering to chronic preventive drug therapies are more likely to engage in other health-promoting behaviors. Failure to account for this relationship may introduce bias in any epidemiologic study evaluating the effect of a preventive therapy on clinical outcomes.
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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.