Evidence map›Paper›PMID 28427340›Full record

ArticleBMC medical research methodology2017

Does the association between adherence to statin medications and mortality depend on measurement approach? A retrospective cohort study.

Mhd Wasem Alsabbagh, Dean Eurich, Lisa M Lix, Thomas W Wilson, David F Blackburn

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In one paragraph

Article in BMC medical research methodology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

10 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Antipsychotic treatment adherence and motor vehicle crash among drivers with schizophrenia: a case-crossover study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Article
  8. Observational
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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

5 authors.

Mhd Wasem AlsabbaghSchool of Pharmacy, University of Waterloo, 10A Victoria St. S., Kitchener, ON, N2G 1C5, Canada. wasem.alsabbagh@uwaterloo.ca.ORCID 0000-0002-2426-9528
Dean EurichDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, Canada.
Lisa M LixDepartment of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Thomas W WilsonDepartment of Medicine, Royal University Hospital, Saskatoon Health Region, Saskatoon, SK, Canada.
David F BlackburnCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to examine the relationship between mortality and statin adherence using two different approaches to adherence measurement (summary versus repeated-measures).

methodsA retrospective cohort study was conducted using administrative data from Saskatchewan, Canada between 1994 and 2008. Eligible individuals received a prescription for a statin following hospitalization for acute coronary syndrome (ACS). Adherence was measured using proportion of days covered (PDC) expressed either as: 1) a fixed summary measure, or 2) as a repeatedly measured covariate. Multivariable Cox-proportional hazards models were used to estimate the association between adherence and mortality.

resultsAmong 9,051 individuals, optimal adherence (≥80%) modeled with a fixed summary measure was not associated with mortality benefits (adjusted HR 0.97, 95% CI 0.86 to 1.09, p = 0.60). In contrast, repeated-measures approach resulted in a significant 25% reduction in the risk of death (adjusted HR 0.75, 95% CI 0.67 to 0.85, p < 0.01).

conclusionsUnlike the summary measure, the repeated measures approach produces a significant reduction of all-cause mortality with optimal adherence. This effect may be a result of the repeated measures approach being more sensitive, or more prone to survival bias. Our findings clearly demonstrate the need to undertake (and report) multiple approaches when assessing the benefits of medication adherence.

Indexed as

Drug MonitoringAcute Coronary SyndromeAgedFemaleHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsKaplan-Meier EstimateLipidsMaleMiddle AgedRetrospective StudiesRisk FactorsSaskatchewanHydroxymethylglutaryl-CoA Reductase InhibitorsLipidsCompliance/adherenceLipids and cholesterolMortalitySecondary preventionTreatment

Identifiers

PMID28427340
PMCPMC5397806

What OpenQuestion holds

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Registered trials

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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.